Organization
CLINICAL CARE ASSOCIATES OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD BARG MD (EXECUTIVE DIRECTOR)
(610) 239-2871
Entity
Organization
Contact information
Practice address
230 W WASHINGTON SQ, 5TH FLOOR, PHILADELPHIA, PA 19106-3500
(215) 829-3668
(215) 829-5002
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(866) 586-2431
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007306640
—
PA
01
—
1413752
BLUE SHIELD
PA
01
—
2101020000
KEYSTONE
PA
01
—
2925755
AETNA
PA
01
—
30002008
KEYSTONE MERCY
PA
01
—
3Y30390
HEALTHNET
PA
01
—
CB8575
RAILROAD MEDICARE
PA
Enumeration date
08/29/2006
Last updated
10/25/2013
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