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General NPI Number Information
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NPI Number | 1184731184
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Entity Type | Organization
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Legal Business Name | NORTH BAY ALLERGY AND ASTHMA
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 1100 PEAR TREE LANE
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City | NAPA
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State | CA
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Zip | 94558
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Country | US
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Telephone | 707-258-8100
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Fax | 707-258-0734
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Provider Business Mailing Address
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Address Line | 1100 PEAR TREE LN
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City | NAPA
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State | CA
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Zip | 94558-6446
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Country | US
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Telephone | 707-258-8100
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Fax | 707-258-0734
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Authorized Official
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Title or Position | OWNER
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Name | SAM S AHN
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Credential | MD
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Telephone | 707-258-8100
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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 |
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License Number State |
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