Healthcare Provider Details

I. General information

NPI: 1609023035
Provider Name (Legal Business Name): ALLERGY MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7435 W AZURE DR SUITE 190
LAS VEGAS NV
89130-4426
US

IV. Provider business mailing address

7435 W AZURE DR SUITE 190
LAS VEGAS NV
89130-4426
US

V. Phone/Fax

Practice location:
  • Phone: 702-363-3666
  • Fax: 702-363-0118
Mailing address:
  • Phone: 702-363-3666
  • Fax: 702-363-0118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number525
License Number StateNV

VIII. Authorized Official

Name: DR. FRANK JOEL MCALLISTER
Title or Position: PHYSICIAN
Credential: DO
Phone: 702-363-3666