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Organization
PENN INTEGRATIVE MEDICAL AND DENTAL CENTER, INC.
Active
Organization
PENN INTEGRATIVE MEDICAL AND DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIAN SANON M.D. (PRESIDENT / OWNER)
(215) 821-2305
Entity
Organization
Contact information
Practice address
7130 RISING SUN AVE, PHILADELPHIA, PA 19111-3957
(215) 821-2305
(215) 220-2600
Mailing address
7130 RISING SUN AVE, PHILADELPHIA, PA 19111-3957
(215) 821-2305
(215) 220-2600
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
171100000X
Acupuncturist
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027913640001
—
PA
Enumeration date
02/07/2013
Last updated
05/03/2013
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