Adult & Child Allergy-Asthma Clinic Inc
Organization Active NPI Allergy & Immunology Physician · Hacienda Heights, CA
NPI 1801909668 · NPPES record last updated Jul 1, 2014
Key facts
- NPI
- 1801909668
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Allergy & Immunology Physician 207K00000X
- License
- G51644 (CA)
- Legal business name
- ADULT & CHILD ALLERGY-ASTHMA CLINIC INC
- Practice address
- 1850 S Azusa Ave Ste 206
Hacienda Heights, CA 91745-6853 - Phone
- (626) 810-5450
- NPI assigned
- Aug 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Stephen Curtis Wong, M.D.
- Title
- Ceo
- Phone
- (626) 284-3400
Practitioners 4
-
Stephen Curtis Wong, M.D.
-
Adrienne Carol Mar Chan, PA-C
-
Marilyn Li, MD
-
Susana Rangel, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091207000082 | CA | Part B Supplier - Clinic/Group Practice | 6507905460 |
Receives reassigned benefits from 1 practitioner Practice locations: Alhambra, CA; Hacienda Heights, CA |
National Provider Directory
Locations
330 S Garfield Ave
Alhambra, CA 91801
Phone (626) 281-3265
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician |
207K00000X | G51644 | CA | Yes |
Addresses
Primary practice location
1850 S Azusa Ave Ste 206
Hacienda Heights, CA 91745-6853
Mailing address
1850 S Azusa Ave Ste 206
Hacienda Heights, CA 91745-6853
Phone (626) 810-5450
NPI Registry JSON
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1404172800000",
"number": "1801909668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 S AZUSA AVE STE 206",
"city": "HACIENDA HEIGHTS",
"state": "CA",
"postal_code": "917456853",
"telephone_number": "626-810-5450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 S AZUSA AVE STE 206",
"city": "HACIENDA HEIGHTS",
"state": "CA",
"postal_code": "917456853",
"telephone_number": "626-810-5450"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADULT & CHILD ALLERGY-ASTHMA CLINIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-16",
"last_updated": "2014-07-01",
"status": "A",
"authorized_official_last_name": "WONG",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "CURTIS",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "626-284-3400",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Allergy & Immunology",
"state": "CA",
"license": "G51644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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All providers in Hacienda Heights, 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 Jul 1, 2014. 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.