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NPI Code Detail

MEDICARE: INTERNAL MEDICINE AND PEDIATRICS ASSOCIATION

MEDICARE: INTERNAL MEDICINE AND PEDIATRICS ASSOCIATION
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 Site38885NC

General Provider Information

NPI Number : 1962720185
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERNAL MEDICINE AND PEDIATRICS ASSOCIATION
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 : 224 HIGH HOUSE RD
Second Line : 100
City : CARY
State : NC
Zip : 27513-4278
Country : US
Telephone Number : 919-380-1189
Fax Number :
Authorized Official
Title or Position : SR DIRECTOR OPERATIONS
Name : KENNY HEINE
Credential :
Telephone Number : 858-625-2990
Provider Enumeration Date : 05/12/2010
Last Update Date : 10/23/2012

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Directions to “INTERNAL MEDICINE AND PEDIATRICS ASSOCIATION ” Practice Location

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