Provider Demographics
NPI:1184222556
Name:MG ALLERGY, INC.
Entity Type:Organization
Organization Name:MG ALLERGY, INC.
Other - Org Name:IMMUNE KNOWLEDGE Y NOW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-239-4000
Mailing Address - Street 1:1501 SUPERIOR AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3634
Mailing Address - Country:US
Mailing Address - Phone:949-239-4000
Mailing Address - Fax:949-209-5449
Practice Address - Street 1:1501 SUPERIOR AVE STE 201
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3634
Practice Address - Country:US
Practice Address - Phone:949-239-4000
Practice Address - Fax:949-209-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty