MEDICARE: ALLIED CLINIC, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1447507413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIED CLINIC, PLLC

Provider Business Mailing Address
First Line	:	4710 N 44TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3834
Country	:	US
Telephone Number	:	602-267-8600
Fax Number	:	480-874-7015

Provider Business Practice Location Address
First Line	:	4710 N 44TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3834
Country	:	US
Telephone Number	:	602-267-8600
Fax Number	:	480-874-7015

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HUNG S LU
Credential	:	M.D.
Telephone Number	:	602-267-8600

Provider Enumeration Date	:	08/09/2012
Last Update Date	:	08/09/2012

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