Allen, Derrick Ross

Allen, Derrick Ross is an individual health care provider with primary practice located at 501 Washington St 510, San Diego CA 92103-2231. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Allen, Derrick Ross can be contacted via phone (619) 849-1729.

Contact Information

Primary practice address
501 Washington St 510 San Diego CA 92103-2231
Phone: (619) 849-1729
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X A69840 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A69840 California

Profile Details

NPI number 1215982970
LBN Legal business name Allen, Derrick Ross
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Apr 12th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215982970 NPPES
California MEDICAID 00A698400

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