Organization
ALLERGY AND ASTHMA CENTER MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE S MIHALAS MD (MEDICAL DOCTOR PHYSICIAN)
(310) 820-1561
Entity
Organization
Contact information
Practice address
11645 WILSHIRE BLVD, STE 988, LOS ANGELES, CA 90025-6809
(310) 820-1561
(310) 826-0895
Mailing address
11645 WILSHIRE BLVD, STE 988, LOS ANGELES, CA 90025-6809
(310) 820-1561
(310) 826-0895
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
G29836
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222793112
—
CA
Enumeration date
09/14/2006
Last updated
03/10/2011
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