MEDICARE: DAVID DREW PINSKY M.D.,

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	207RA0401X	Addiction Medicine (Internal Medicine) Physician	G55092	CA

General Provider Information

NPI Number	:	1871677724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID DREW PINSKY M.D.,

Provider Business Mailing Address
First Line	:	1050 BEVERLY WAY
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-2516
Country	:	US
Telephone Number	:	626-799-4151
Fax Number	:	626-799-4207

Provider Business Practice Location Address
First Line	:	2050 HUNTINGTON DR
Second Line	:	SUITE D
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4900
Country	:	US
Telephone Number	:	626-799-4151
Fax Number	:	626-799-4207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/29/2007

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