Basic Information
| Provider Information | |||||||||
| NPI: | 1639243181 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HENG | ||||||||
| FirstName: | ALLEN | ||||||||
| MiddleName: | K. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3550 Q ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933011662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613235918 | ||||||||
| FaxNumber: | 6613234703 | ||||||||
| Practice Location | |||||||||
| Address1: | 27300 IRIS AVE | ||||||||
| Address2: | |||||||||
| City: | MORENO VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925554802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512430811 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A33201 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 00A332010 | 05 | CA | MEDICAID |