NPI 1053576835

Upenn Life

Organisation Health Maintenance Organization Philadelphia, PA

Practice location

Address: 4508 Chestnut St, Philadelphia, PA 19139-3608
Phone: (215) 573-7200

Authorised official

Name: Bruce Kinosian
Title: Medical Director
Phone: (215) 573-7200

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence MD421701 (PA)

Other Health Maintenance Organization providers in Pennsylvania →

Registry record

NPI: 1053576835
Entity type: Organization
NPI issued: 22 Jul 2008
Record last updated: 22 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.