Allergy & Asthma Medical Clinic,Inc
Organization Active NPI Allergy & Immunology Physician · Merced, CA
NPI 1447370804 · NPPES record last updated Oct 1, 2008
Key facts
- NPI
- 1447370804
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Allergy & Immunology Physician 207K00000X
- License
- A262450 (CA)
- Legal business name
- ALLERGY & ASTHMA MEDICAL CLINIC,INC
- Practice address
- 750 W Olive Ave Ste 103
Merced, CA 95348-2436 - Phone
- (209) 383-6868
- Fax
- (209) 383-0760
- NPI assigned
- Mar 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Mohan P. Reddy, M.D.
- Title
- M.D.
- Phone
- (209) 383-6868
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081022000358 | CA | Part B Supplier - Clinic/Group Practice | 7719045905 |
Receives reassigned benefits from 1 practitioner Practice locations: Los Banos, CA; Merced, CA; Turlock, CA |
National Provider Directory
Locations
650 I St
Ste G
Los Banos, CA 93635
Phone (209) 826-4666
750 W Olive Ave
Ste 103
Merced, CA 95348
Phone (209) 383-6868
1110 Delbon Ave
Turlock, CA 95382
Phone (209) 410-5500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician |
207K00000X | A262450 | CA | Yes |
Addresses
Primary practice location
750 W Olive Ave Ste 103
Merced, CA 95348-2436
Mailing address
750 W Olive Ave Ste 103
Merced, CA 95348-2436
Phone (209) 383-6868
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A262450 | Medicaid | CA |
Other providers in Merced, CA
- Hargurbir Alhuwalia
- Farhana Ali
- George Samir Alkhouri
- All Ways Services LLC
- Alazja Geneva Allen
- Lourdes Marie Almaguer
- Cyd Cynthia Danganan Almeda
- Tiffani Alocer
- Neida Marys Alonso
- Alpha Pregnancy Help Center
All providers in Merced, CA · Allergy & Immunology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.