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General NPI Number Information
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NPI Number | 1730990581
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Entity Type | Organization
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Legal Business Name | LAN & OCEAN AESTHETICS ALLERGY AND PRIMARY CARE LLC
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 3883 ROGERS BRIDGE RD STE 604
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City | DULUTH
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State | GA
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Zip | 30097-2849
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Country | US
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Telephone | 601-519-9562
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Fax |
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Provider Business Mailing Address
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Address Line | 3883 ROGERS BRIDGE RD STE 604
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City | DULUTH
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State | GA
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Zip | 30097-2849
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Country | US
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Telephone | 601-519-9562
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/MANAGER
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Name | LAN ZHOU
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Credential | MD
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Telephone | 601-519-9562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number |
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License Number State |
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