Provider Demographics
NPI:1205998663
Name:ALLERGY & ASTHMA CENTER PC
Entity type:Organization
Organization Name:ALLERGY & ASTHMA CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT MD
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-485-0316
Mailing Address - Street 1:330 S GARDEN WAY
Mailing Address - Street 2:STE 150
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8176
Mailing Address - Country:US
Mailing Address - Phone:541-485-0316
Mailing Address - Fax:541-431-0317
Practice Address - Street 1:330 S GARDEN WAY
Practice Address - Street 2:STE 150
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8176
Practice Address - Country:US
Practice Address - Phone:541-485-0316
Practice Address - Fax:541-431-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR247624Medicaid
R0000WFBBNMedicare PIN