Penn Integrative Medical and Dental Center, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PENN INTEGRATIVE MEDICAL AND DENTAL CENTER, INC.

Practice address

7130 Rising Sun Ave
Philadelphia, PA 19111-3957

Phone

(215) 821-2305

Fax

(215) 220-2600

NPI assigned

Feb 7, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Julian Sanon, M.D.

Title

President / Owner

Phone

(215) 821-2305

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pimd Dental

  • Dentist
  • Philadelphia, PA
  • NPI 1326417551
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1952640187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113957",
            "telephone_number": "215-821-2305",
            "fax_number": "215-220-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7130 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113957",
            "telephone_number": "215-821-2305",
            "fax_number": "215-220-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN INTEGRATIVE MEDICAL AND DENTAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "SANON",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "215-821-2305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027913640001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penn Ergonomics, LLC
• Penn Executive Diagnostic Center, Inc.
• Penn Executive Diagnostic Center, Inc.
• Penn Hope Transport Inc
• Penn House Homecare LLC
• Penn Medical Associates PC
• Penn Medicine CCP
• Penn Neuromuscular Diagnostics, LLC
• Penn Presbyterian Medical Center
• Penn Presbyterian Medical Center

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.