Provider Demographics
NPI:1053751875
Name:ALLEN, ASHLEY REBEKAH (MD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:REBEKAH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:REBEKAH
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:82 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3085
Mailing Address - Country:US
Mailing Address - Phone:714-362-7024
Mailing Address - Fax:
Practice Address - Street 1:2051 MARENGO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1352
Practice Address - Country:US
Practice Address - Phone:233-409-7053
Practice Address - Fax:323-226-7927
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA667709163WX0003X
390200000X
CAA186620207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program