Mutnick Allergy & Asthma, L.L.C.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

Legal business name

MUTNICK ALLERGY & ASTHMA, L.L.C.

Practice address

9705 45TH Ave N
Minneapolis, MN 55442-2555

Phone

(714) 296-6777

NPI assigned

Feb 13, 2023

Last updated

Feb 13, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jack Mutnick, MDNPI 1487601316

Title

Owner

Phone

(714) 296-6777

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack Leon-Max Mutnick, M.D.

  • Internal Medicine Physician
  • Edina, MN
  • NPI 1487601316
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1538866231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 UNDERWOOD LN N UNIT E",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554424516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9705 45TH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554422555",
            "telephone_number": "714-296-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUTNICK ALLERGY & ASTHMA, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "MUTNICK",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-296-6777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mumtaz Mustapha, MD
• Tandiwe Musukwa
• John Andrew Muthama, MD
• Sarah Muthoni
• Brian Kirti Muthyala, MD
• Micheline Mutombo-Harris
• Melinda Mutschler, PA
• Mounika Muttineni, DO
• Jill Mutziger Johnson, PHARMD
• Bilqis Siddiqah Muzaffarr, APRN, CNP

• Allergy Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Allergy Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.