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NPI Code Detail

MEDICARE: UPMC COMMUNITY MEDICINE INC

MEDICARE: UPMC COMMUNITY MEDICINE 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
1332900000XNon-Pharmacy Dispensing SiteOS010194LPA

General Provider Information

NPI Number : 1770811101
Entity Type Code : Organization
Provider Name (Legal Business Name) : UPMC COMMUNITY MEDICINE INC
Provider Business Mailing Address
First Line : 5626 OBERLIN DR
Second Line : SUITE 110
City : SAN DIEGO
State : CA
Zip : 92121-1705
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20630 ROUTE 19
Second Line : 101
City : CRANBERRY TOWNSHIP
State : PA
Zip : 16066-6021
Country : US
Telephone Number : 724-779-2273
Fax Number :
Authorized Official
Title or Position : VP OF OPERATIONS
Name : KENNY HEINE
Credential :
Telephone Number : 858-625-2990
Provider Enumeration Date : 11/23/2009
Last Update Date : 05/15/2013

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