MEDICARE: THE PHILIP JAISOHN MEMORIAL FOUNDATION INC

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	207Q00000X	Family 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	:	1366498479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PHILIP JAISOHN MEMORIAL FOUNDATION INC

Provider Business Mailing Address
First Line	:	6705 OLD YORK RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19126-2841
Country	:	US
Telephone Number	:	215-224-2000
Fax Number	:	215-224-8651

Provider Business Practice Location Address
First Line	:	6705 OLD YORK RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19126-2841
Country	:	US
Telephone Number	:	215-224-2000
Fax Number	:	215-224-8651

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	MR. GEORGE JUNG SOO CHOE
Credential	:	PRESIDENT & CEO
Telephone Number	:	215-224-2000

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	10/20/2025

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