Organization
ALLERGY CONSULTANTS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIONISIO A FERNANDES M.D. (PRESIDENT)
(510) 537-0700
Entity
Organization
Contact information
Practice address
20055 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5333
(510) 537-0700
(510) 537-7795
Mailing address
20055 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5333
(510) 537-0700
(510) 537-7795
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A294160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0066330
—
CA
Enumeration date
05/04/2006
Last updated
07/17/2007
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