NPI Code Detail JSON Logo

1508527797 NPI number — MODENA ALLERGY & ASTHMA INC.

NPI Number: 1508527797
Health Care Provider/Practitioner: MODENA ALLERGY & ASTHMA INC.

Information about “1508527797” NPI (MODENA ALLERGY & ASTHMA INC.) exists in 1508527797 in HTML format HTML  |  1508527797 in plain Text format TXT  |  1508527797 in PDF (Portable Document Format) PDF  |  1508527797 in an XML format XML  formats.

NPI Number : 1508527797 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508527797",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MODENA ALLERGY & ASTHMA INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9850 GENESEE AVE STE 710",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LA JOLLA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92037-1218",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "858-283-3963",
    "MailingAddressFaxNumber": "858-332-1811",
    "FirstLinePracticeLocationAddress": "9850 GENESEE AVE STE 710",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LA JOLLA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92037-1218",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "858-283-3963",
    "PracticeLocationAddressFaxNumber": "858-332-1811",
    "EnumerationDate": "01/10/2022",
    "LastUpdateDate": "09/09/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MODENA",
    "AuthorizedOfficialFirstName": "BRIAN",
    "AuthorizedOfficialMiddleName": "D",
    "AuthorizedOfficialTitle": "DIRECTOR & SECRETARY",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD, MSC",
    "AuthorizedOfficialTelephoneNumber": "412-689-0636",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2080P0214X",
          "TaxonomyName": "Pediatric Pulmonology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207KI0005X",
          "TaxonomyName": "Clinical & Laboratory Immunology (Allergy & Immunology) Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207KA0200X",
          "TaxonomyName": "Allergy Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RA0201X",
          "TaxonomyName": "Allergy & Immunology (Internal Medicine) Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207K00000X",
          "TaxonomyName": "Allergy & Immunology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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