Organization
PREMIUM ALLERGY
Active
Other names
Premium Allergy & Respiratory Center
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA LEAL (MANAGER)
(559) 387-5230
Entity
Organization
Contact information
Practice address
1069 E CHAMPLAIN DR STE A, FRESNO, CA 93720-4223
(559) 387-5230
(559) 900-7952
Mailing address
2021 HERNDON AVE STE 201, CLOVIS, CA 93611-6317
(559) 387-5230
(559) 900-7952
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
207KA0200X
Allergy Physician
—
—
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
—
2080P0201X
Pediatric Allergy/Immunology Physician
—
—
Other
Enumeration date
12/13/2023
Last updated
02/28/2024
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