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Organization
MOUNTAINSIDE ALLERGY AND IMMUNOLOGY GROUP
Active
Organization
MOUNTAINSIDE ALLERGY AND IMMUNOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN DEANE M.D. (PRESIDENT)
(916) 452-6222
Entity
Organization
Contact information
Practice address
4801 J ST STE B, SACRAMENTO, CA 95819-3746
(916) 452-6222
(916) 451-5534
Mailing address
PO BOX 19066, SACRAMENTO, CA 95819-0066
(916) 452-6222
(916) 451-5534
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
NULL
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Enumeration date
02/07/2012
Last updated
09/15/2014
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