| Organization Name: | ALLERGY ASTHMA SINUS MEDICAL CENTER |
| NPI Number: | 1083857742 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JORGE A. QUEL (DIRECTOR) |
| Mailing Address: | 4644 Lincoln Blvd Ste 410 Marina Del Rey |
| State: | CA US |
| Postal Code: | 902926390 |
| Phone Number: | 3108236766 |
| Fax Number: | 3108236966 |
| NPI Enumeration Date: | 04/10/2009 |
| NPI Last Update Date: | 04/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KI0005X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Clinical & Laboratory Immunology |
| Taxonomy Definition: | |