Allergy & Immunology Clinic of East Bay

Organization Active NPI Medical Specialty Clinic/Center · Berkeley, CA

NPI 1205159258 · NPPES record last updated Mar 4, 2010

Key facts

NPI
1205159258
Entity type
Organization (NPI type 2)
Primary specialty
Medical Specialty Clinic/Center 261QM2500X
License
A83416 (CA)
Legal business name
ALLERGY & IMMUNOLOGY CLINIC OF EAST BAY
Practice address
2320 Woolsey St
Ste 314
Berkeley, CA 94705-1973
Phone
(925) 270-5113
Fax
(925) 962-9955
NPI assigned
Mar 4, 2010
Organization subpart
No

Authorized official

Name
Dmitriy Sukhov
Title
General Manager
Phone
(925) 270-5119

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X A83416 CA Yes

Addresses

Primary practice location

2320 Woolsey St
Ste 314
Berkeley, CA 94705-1973

Mailing address

111 Calle la Montana
Moraga, CA 94556-1607

Other providers in Berkeley, CA

All providers in Berkeley, CA · Medical Specialty Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.