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PHILIP JAISOHN MEMORIAL CENTER NPI 1366498479


NPI Information

NPI: 1366498479
Provider Name: PHILIP JAISOHN MEMORIAL CENTER

Doing Business As: JAISOHN MEDICAL CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 39D1033803

Address:
6705 OLD YORK RD
PHILADELPHIA, PA
ZIP 19126
Phone: (215) 224-2000
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PHILIP JAISOHN MEMORIAL CENTER is a family medicine in Philadelphia, PA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PHILIP JAISOHN MEMORIAL CENTER NPI is 1366498479. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Jaisohn Medical Center.

The provider's business location address is:

6705 OLD YORK RD
PHILADELPHIA, PA
ZIP 19126-841
Phone: (215) 224-2000
Fax: (215) 224-8651

The provider's authorized official is Hack Ryang Chung .
The authorized official title is Chairman and has the following contact phone number (215) 224-2000.

The CLIA number assigned to this NPI record is 39D1033803 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10007340700003MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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