Provider Demographics
NPI:1952468381
Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES LTD
Entity Type:Organization
Organization Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-949-7377
Mailing Address - Street 1:7514 E MONTEREY WAY
Mailing Address - Street 2:STE 1
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6900
Mailing Address - Country:US
Mailing Address - Phone:480-949-7377
Mailing Address - Fax:480-949-8339
Practice Address - Street 1:7514 E MONTEREY WAY
Practice Address - Street 2:STE1
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6900
Practice Address - Country:US
Practice Address - Phone:480-949-7377
Practice Address - Fax:480-949-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17209174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCHMSOtherMEDICARE GROUP ID #
AZ113358Medicaid
AZ626202Medicaid
AZ218166Medicaid
AZ873415Medicaid
AZ03WCHMS02Medicare ID - Type Unspecified
AZZWCHMSOtherMEDICARE GROUP ID #
AZ626202Medicaid
AZ218166Medicaid
AZ113358Medicaid
AZH52081Medicare UPIN
AZ03WCHHMS04Medicare ID - Type Unspecified
AZ80786Medicare ID - Type Unspecified