Healthcare Provider Details

I. General information

NPI: 1851254924
Provider Name (Legal Business Name): KEYSTONE PHYSICIANS DIRECT PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 CALIFORNIA AVE
PITTSBURGH PA
15202-2469
US

IV. Provider business mailing address

620 CALIFORNIA AVE
PITTSBURGH PA
15202-2469
US

V. Phone/Fax

Practice location:
  • Phone: 412-254-6323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANNA OWEN
Title or Position: OWNER, CLINICAL PHYSICIAN
Credential: MD
Phone: 412-254-6323