Joanne Hartley Allport, M.D., M.P.H.

Individual provider Active NPI Pediatric Adolescent Medicine Physician · Benicia, CA

NPI 1811096332 · NPPES record last updated Jan 26, 2011

Key facts

NPI
1811096332
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Adolescent Medicine Physician 2080A0000X
License
G046934 (CA)
Practice address
2137 Via Alta
Benicia, CA 94510-2319
Phone
(707) 208-0845
Fax
(707) 208-0845
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G046934CAMDPediatric Adolescent Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X G046934 CA Yes

Addresses

Primary practice location

2137 Via Alta
Benicia, CA 94510-2319

Mailing address

2137 Via Alta
Benicia, CA 94510-2319
Phone (707) 208-0845

Other providers in Benicia, CA

All providers in Benicia, CA · Pediatric Adolescent Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.