Provider Demographics
NPI:1730990581
Name:LAN & OCEAN AESTHETICS ALLERGY AND PRIMARY CARE LLC
Entity type:Organization
Organization Name:LAN & OCEAN AESTHETICS ALLERGY AND PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-519-9562
Mailing Address - Street 1:3883 ROGERS BRIDGE RD STE 604
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2849
Mailing Address - Country:US
Mailing Address - Phone:601-519-9562
Mailing Address - Fax:
Practice Address - Street 1:3883 ROGERS BRIDGE RD STE 604
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-2849
Practice Address - Country:US
Practice Address - Phone:601-519-9562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty