# MOUNTAINSIDE ALLERGY AND IMMUNOLOGY GROUP

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

## Provider details

- **NPI number:** 1306118294
- **Authorized official:** DR. SEAN DEANE M.D. (PRESIDENT)
- **Authorized official phone:** (916) 452-6222

## Contact information

- **Practice address:** 4801 J ST STE B, SACRAMENTO, CA 95819-3746
- **Practice address phone:** (916) 452-6222
- **Practice address fax:** (916) 451-5534
- **Mailing address:** PO BOX 19066, SACRAMENTO, CA 95819-0066
- **Mailing address phone:** (916) 452-6222
- **Mailing address fax:** (916) 451-5534

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | Yes |
| 207K00000X | Allergy & Immunology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/07/2012
- **Last updated:** 09/15/2014