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General NPI Number Information
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NPI Number | 1316120843
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Entity Type | Organization
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Legal Business Name | SONORAN ALLERGY & ASTHMA CENTER, PC
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 7312 E DEER VALLEY RD SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-7452
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Country | US
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Telephone | 480-563-9810
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Fax | 480-563-4132
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Provider Business Mailing Address
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Address Line | 7312 E DEER VALLEY RD SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-7452
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Country | US
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Telephone | 480-563-9810
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Fax | 480-563-4132
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAURA ISPAS-PONAS
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Credential | M.D.
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Telephone | 480-563-9810
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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 | 29320
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License Number State | AZ
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