Provider Demographics
NPI:1265486765
Name:PRIMARY CARE EAST LLC
Entity Type:Organization
Organization Name:PRIMARY CARE EAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NOBUO
Authorized Official - Last Name:ARISUMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-673-0214
Mailing Address - Street 1:2001 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:WHITE OAK
Mailing Address - State:PA
Mailing Address - Zip Code:15131-2419
Mailing Address - Country:US
Mailing Address - Phone:412-673-0214
Mailing Address - Fax:412-673-0215
Practice Address - Street 1:2001 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-2419
Practice Address - Country:US
Practice Address - Phone:412-673-0214
Practice Address - Fax:412-673-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012437210001Medicaid
PA087057Medicare ID - Type Unspecified