Provider Demographics
NPI:1245383009
Name:ALLERGY AND ASTHMA INSTITUTE OF THE VALLEY
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA INSTITUTE OF THE VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-366-8112
Mailing Address - Street 1:10515 BALBOA BLVD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6343
Mailing Address - Country:US
Mailing Address - Phone:818-366-8112
Mailing Address - Fax:818-366-6002
Practice Address - Street 1:10515 BALBOA BLVD
Practice Address - Street 2:SUITE 390
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6343
Practice Address - Country:US
Practice Address - Phone:818-366-8112
Practice Address - Fax:818-366-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty