Provider Demographics
NPI:1508857079
Name:PINSKY, IRINA (DPM)
Entity Type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:
Last Name:PINSKY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 SAN GABRIEL BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-4394
Mailing Address - Country:US
Mailing Address - Phone:323-724-0019
Mailing Address - Fax:323-248-7044
Practice Address - Street 1:450 E HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3748
Practice Address - Country:US
Practice Address - Phone:626-462-1884
Practice Address - Fax:626-445-5034
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4421213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E44210Medicaid
CA000E44210Medicaid
CAE4421Medicare ID - Type Unspecified