1164474292 NPI number — DESERT ALLERGY, ASTHMA & IMMUNOLOGY, LLP

Table of content: ARNOLD SETH BINGHAM LPN (NPI 1467755983)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164474292 NPI number — DESERT ALLERGY, ASTHMA & IMMUNOLOGY, LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DESERT ALLERGY, ASTHMA & IMMUNOLOGY, LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164474292
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
129 W LAKE MEAD PKWY
Provider Second Line Business Mailing Address:
#B-18
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89015-7055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-564-4440
Provider Business Mailing Address Fax Number:
702-558-1522

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2821 W HORIZON RIDGE PKWY
Provider Second Line Business Practice Location Address:
#101
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89052-4427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-564-4440
Provider Business Practice Location Address Fax Number:
702-558-1522
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCKNIGHT
Authorized Official First Name:
A
Authorized Official Middle Name:
SEAN
Authorized Official Title or Position:
CORPORATE PARTNER
Authorized Official Telephone Number:
702-564-4440

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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