# ALLERGY MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1639234354
- **Authorized official:** JOY VERNON (BILLER)
- **Authorized official phone:** (310) 478-0964

## Contact information

- **Practice address:** 11620 WILSHIRE BLVD, SUITE 200, LOS ANGELES, CA 90025-1706
- **Practice address phone:** (310) 312-5050
- **Practice address fax:** (310) 575-9292
- **Mailing address:** 11620 WILSHIRE BLVD, SUITE 200, LOS ANGELES, CA 90025-1706
- **Mailing address phone:** (310) 312-5050
- **Mailing address fax:** (310) 575-9292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207KI0005X | Clinical & Laboratory Immunology (Allergy & Immunology) Physician | — | CA | Yes |

## Other

- **Enumeration date:** 12/22/2006
- **Last updated:** 08/22/2020