Provider Demographics
NPI:1720367972
Name:ALLERGY & ASTHMA CENTER
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-463-6900
Mailing Address - Street 1:8008 MONET AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-7509
Mailing Address - Country:US
Mailing Address - Phone:909-463-6900
Mailing Address - Fax:909-463-1430
Practice Address - Street 1:8008 MONET AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-7509
Practice Address - Country:US
Practice Address - Phone:909-463-6900
Practice Address - Fax:909-463-1430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70227207KA0200X, 207RA0201X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/ImmunologyGroup - Multi-Specialty