Healthcare Provider Details

I. General information

NPI: 1447507413
Provider Name (Legal Business Name): ALLIED CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 N 44TH ST
PHOENIX AZ
85018-3834
US

IV. Provider business mailing address

4710 N 44TH ST
PHOENIX AZ
85018-3834
US

V. Phone/Fax

Practice location:
  • Phone: 602-267-8600
  • Fax: 480-874-7015
Mailing address:
  • Phone: 602-267-8600
  • Fax: 480-874-7015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HUNG S LU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 602-267-8600