Active NPI
Forrest B. Allen, MD
- Anesthesiology Physician
- La Mesa, CA
National Provider Identifier
1639227622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G43004
- Practice address
- 9790 Marky Way
La Mesa, CA 91941-5626 - Phone
- (619) 985-1002
- NPI assigned
- Jan 8, 2007
- Last updated
- Aug 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G43004 | CA | Primary |
Addresses
Primary practice location
9790 Marky Way
La Mesa, CA 91941-5626
Mailing address
9790 Marky Way
La Mesa, CA 91941-5626
Phone (619) 985-1002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43004 | CA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1639227622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9790 MARKY WAY",
"city": "LA MESA",
"state": "CA",
"postal_code": "919415626",
"telephone_number": "619-985-1002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9790 MARKY WAY",
"city": "LA MESA",
"state": "CA",
"postal_code": "919415626",
"telephone_number": "619-985-1002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "FORREST",
"middle_name": "B.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G43004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.