Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 23830 | AZ |
NPI | 1255415253 |
---|---|
Provider Name | Linda Alvarez-Thull |
First Address | Scottsdale, AZ 85258-4510 |
Second Address | Scottsdale, AZ 85258-4510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F96813 | (02) |