# LAKESIDE ALLERGY ASTHMA AND IMMUNOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104365279
- **Authorized official:** LI ZUO MD (CEO)
- **Authorized official phone:** (513) 535-0946

## Contact information

- **Practice address:** 3500 DULUTH PARK LN STE 820, DULUTH, GA 30096-3243
- **Practice address phone:** (678) 226-9866
- **Practice address fax:** (678) 373-3983
- **Mailing address:** PO BOX 2227, DULUTH, GA 30096-0039
- **Mailing address phone:** (678) 837-5224
- **Mailing address fax:** (404) 860-1298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 75964 | GA | Yes |

## Other

- **Enumeration date:** 02/21/2017
- **Last updated:** 10/19/2022