Healthcare Provider Details

I. General information

NPI: 1922099498
Provider Name (Legal Business Name): ARIZONA ASTHMA & ALLERGY INSTITUTE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13965 N. 75TH AVENUE
PEORIA AZ
85381-6097
US

IV. Provider business mailing address

13965 N. 75TH AVENUE
PEORIA AZ
85381-6097
US

V. Phone/Fax

Practice location:
  • Phone: 602-843-2991
  • Fax: 602-978-1226
Mailing address:
  • Phone: 602-843-2991
  • Fax: 602-978-1226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: TODD MCGEE
Title or Position: COO
Credential: COO
Phone: 602-734-0252