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General NPI Number Information
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NPI Number | 1124163902
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Entity Type | Organization
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Legal Business Name | SOUTHERN UTAH ALLERGY AND ASTHMA CLINIC PC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1490 E FOREMASTER DR STE 260
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City | SAINT GEORGE
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State | UT
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Zip | 84790-4502
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Country | US
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Telephone | 435-688-1128
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Fax | 435-673-4045
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Provider Business Mailing Address
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Address Line | 1490 E FOREMASTER DR STE 260
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City | SAINT GEORGE
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State | UT
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Zip | 84790-4502
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Country | US
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Telephone | 435-688-1128
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Fax | 435-673-4045
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH R PINNA
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Credential | MD
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Telephone | 435-688-1128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 5416150-1205
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License Number State | UT
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