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General NPI Number Information
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NPI Number | 1366527889
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Entity Type | Organization
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Legal Business Name | ALPINE ALLERGY AND ASTHMA ASSOCIATES INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 3254 PROFESSIONAL DRIVE
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City | AUBURN
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State | CA
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Zip | 95602-2412
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Country | US
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Telephone | 530-888-1016
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Fax | 530-888-1346
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Provider Business Mailing Address
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Address Line | 300 SIERRA COLLEGE DR STE 235
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5082
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Country | US
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Telephone | 530-273-6530
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Fax | 530-273-3951
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Authorized Official
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Title or Position | SECRETARY
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Name | ALLISON LACEY MCCORMICK
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Credential | M.D.
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Telephone | 530-888-1016
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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 | CA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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