Organization
ALLERGY & IMMUNOLOGY CLINIC OF EAST BAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRIY SUKHOV (GENERAL MANAGER)
(925) 270-5119
Entity
Organization
Contact information
Practice address
2320 WOOLSEY ST, STE 314, BERKELEY, CA 94705-1973
(925) 270-5113
(925) 962-9955
Mailing address
111 CALLE LA MONTANA, MORAGA, CA 94556-1607
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A83416
CA
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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