Blackburn, Allie Kieran
Blackburn, Allie Kieran is an individual health care provider with primary practice located at 1516 Cotner Ave , Los Angeles CA 90025-3303. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Blackburn, Allie Kieran can be contacted via phone (310) 445-2951.Contact Information
Primary practice address
1516 Cotner Ave
Los Angeles CA 90025-3303
Phone: (310) 445-2951
Fax: (310) 479-1459
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | A89524 | California |
Profile Details
| NPI number | 1649310780 |
|---|---|
| LBN Legal business name | Blackburn, Allie Kieran |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 7th, 2007 |
| Last updated | May 11th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649310780 | NPPES |
| California | MEDICAID | 00A895240 |
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