Basic Information
| Provider Information | |||||||||
| NPI: | 1861400988 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HABAS | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 231189 | ||||||||
| Address2: | |||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920231189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602302251 | ||||||||
| FaxNumber: | 7602302253 | ||||||||
| Practice Location | |||||||||
| Address1: | 354 SANTA FE DR | ||||||||
| Address2: | |||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920245142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602302251 | ||||||||
| FaxNumber: | 7602302253 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D63312 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | D63312 | MD | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | C133537 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 409457300 | 05 | MD | MEDICAID | S138-0093 | 01 | MD | CAREFIRST REGIONAL | OTHER | KJ15GB/ 64710401 | 01 | MD | CAREFIRST MARYLAND | OTHER |