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General NPI Number Information
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NPI Number | 1447601489
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Entity Type | Organization
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Legal Business Name | ALLERGY TESTING GROUP OF CALIFORNIA INC
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Dates
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Enumeration Date | 06/30/2016
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Last Update Date | 06/30/2016
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Provider Practice Location Address
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Address Line | 13966 VALLEY VIEW AVE
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City | LA MIRADA
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State | CA
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Zip | 90638-3503
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Country | US
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Telephone | 844-865-5677
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Fax |
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Provider Business Mailing Address
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Address Line | 13966 VALLEY VIEW AVE
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City | LA MIRADA
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State | CA
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Zip | 90638-3503
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Country | US
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Telephone | 844-865-5677
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Fax |
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | VANESSA ALVAREZ
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Credential |
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Telephone | 844-865-5677
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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 | 87291
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License Number State | CA
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