Organization
ALLERGY MEDICAL GROUP, INC.
Active
Other names
AMG, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN T CHIU M.D. (CEO OWNER)
(949) 644-9424
Entity
Organization
Contact information
Practice address
400 NEWPORT CENTER DR, SUITE 401, NEWPORT BEACH, CA 92660-7601
(949) 644-9424
(949) 644-1424
Mailing address
400 NEWPORT CENTER DR, SUITE 401, NEWPORT BEACH, CA 92660-7601
(949) 644-9424
(949) 644-1424
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
W080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ70106Z
BLUE SHIELD
CA
05
—
ZZZ70106Z
—
CA
Enumeration date
05/29/2007
Last updated
05/19/2008
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