Organization
WEST DERMATOLOGY OF PENNSYLVANIA A PROFESSIONAL MEDICAL CORPORATION
Active
Parent organization
J. ROBERT WEST, M.D., INC
Other names
J. Robert West, M.D., Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
J. ROBERT WEST, M.D., INC
Authorized official
JOHN ROBERT WEST M.D. (PRESIDENT)
(909) 335-8649
Entity
Organization
Contact information
Practice address
150 W BEAU ST, SUITE 308, WASHINGTON, PA 15301-4425
(724) 225-1505
(724) 225-5810
Mailing address
PO BOX 2199, REDLANDS, CA 92373-0721
(909) 335-8649
(909) 557-1953
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD432414
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN4267
RAILROAD MEDICARE WEST DERM OF PA
PA
01
—
MD432414
MEDICAL LICENSE
PA
01
—
RU2030643
HIGHMARK BLUE SHIELD
PA
Enumeration date
05/08/2008
Last updated
12/08/2008
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