MEDICARE: PRIMARY CARE EAST LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265486765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE EAST LLC

Provider Business Mailing Address
First Line	:	2001 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131-2419
Country	:	US
Telephone Number	:	412-673-0214
Fax Number	:	412-673-0215

Provider Business Practice Location Address
First Line	:	2001 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131-2419
Country	:	US
Telephone Number	:	412-673-0214
Fax Number	:	412-673-0215

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. DAVID NOBUO ARISUMI
Credential	:	M.D.
Telephone Number	:	412-673-0214

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/22/2020

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