MEDICARE: ALLERGY ASTHMA CLINIC LTD

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	207K00000X	Allergy & Immunology Physician

General Provider Information

NPI Number	:	1609834373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY ASTHMA CLINIC LTD

Provider Business Mailing Address
First Line	:	300 W CLARENDON AVE
Second Line	:	STE 120
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3421
Country	:	US
Telephone Number	:	602-277-3337
Fax Number	:	602-277-3330

Provider Business Practice Location Address
First Line	:	300 W CLARENDON AVE
Second Line	:	STE 120
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3421
Country	:	US
Telephone Number	:	602-277-3337
Fax Number	:	602-277-3330

Authorized Official
Title or Position	:	OWNER PHYSICIAN
Name	:	DR. MARK SAMUEL SCHUBERT
Credential	:	MD
Telephone Number	:	602-277-3337

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	08/22/2020

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