Healthcare Provider Details

I. General information

NPI: 1316501273
Provider Name (Legal Business Name): CLEAR ALLERGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3831 HUGHES AVE
CULVER CITY CA
90232-2751
US

IV. Provider business mailing address

3831 HUGHES AVE
CULVER CITY CA
90232-2751
US

V. Phone/Fax

Practice location:
  • Phone: 424-603-4544
  • Fax: 424-603-4546
Mailing address:
  • Phone: 424-603-4544
  • Fax: 424-603-4546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAFFI TACHDJIAN
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 310-998-0060