LAKESIDE ALLERGY ASTHMA AND IMMUNOLOGY LLC (NPI# 1104365279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104365279 |
| Entity Type | Organization |
| Organization Name | LAKESIDE ALLERGY ASTHMA AND IMMUNOLOGY LLC |
| Practice Address |
3790 Pleasant Hill Rd Suite 200 Duluth GA 30096-5142 |
| Mailing Address |
Po Box 2227 Duluth GA 30096-0039 |
| Practice Telephone | 6788375224 |
| Mailing Telephone | 6788375224 |
| Mailing Fax Number | 4048601298 |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-03-07 |
| Authorized Official Name | LI ZUO (CEO) |
| Authorized Official Telephone | 5135350946 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
75964 | GA | Ambulatory Health Care Facilities |
| Street Address |
3790 PLEASANT HILL RD SUITE 200 |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-5142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023225190 | Li Zuo | Allergy & Immunology | 3790 Pleasant Hill Rd, Suite 200, Duluth, GA 30096-5142 | 2007-05-17 |
| 1134667124 | Sarah Regina D'urso | Physical Therapist | 3790 Pleasant Hill Rd, Ste 100, Duluth, GA 30096-5142 | 2017-02-09 |
| 1477007342 | Allyson Nicole Riedel | Physical Therapist | 3790 Pleasant Hill Rd, Ste 100, Duluth, GA 30096-5142 | 2016-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
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| 1073540902 | Austin & Treacy, P.a. | Clinic/Center | 324 W Superior St, 800 Medical Arts, Duluth, MN 55802-1701 | 2006-06-27 |
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| 1477005593 | Hirenirali LLC | Clinic/Center | 12390 Beragio Pl, Alpharetta, GA 30004-4188 | 2016-10-25 |
| 1851840961 | Tele Doctor Direct Inc | Clinic/Center | 1250 Powers Ferry Cmn Se, Suite 100, Marietta, GA 30067-6046 | 2016-09-30 |
| 1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.