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General NPI Number Information
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NPI Number | 1003991753
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Entity Type | Organization
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Legal Business Name | DESERT CENTER FOR ALLERGY AND CHEST DISEASES
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 02/13/2019
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Provider Practice Location Address
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Address Line | 6970 E CHAUNCEY LN STE 100
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City | PHOENIX
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State | AZ
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Zip | 85054-5158
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Country | US
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Telephone | 602-788-7211
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Fax | 602-788-1890
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Provider Business Mailing Address
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Address Line | 6970 E CHAUNCEY LN STE 100
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City | PHOENIX
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State | AZ
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Zip | 85054-5158
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Country | US
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Telephone | 602-788-7211
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Fax | 602-788-1890
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | MRS. LISA STUBBLEFIELD
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Credential |
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Telephone | 602-788-7211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 1549
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 31223
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 1549
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License Number State | AZ
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