Provider Demographics
NPI:1598406381
Name:CENTER FOR PAN ASIAN COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:CENTER FOR PAN ASIAN COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-446-0929
Mailing Address - Street 1:6185 BUFORD HWY BLDG B
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-2350
Mailing Address - Country:US
Mailing Address - Phone:770-446-0929
Mailing Address - Fax:
Practice Address - Street 1:6185 BUFORD HWY BLDG B
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30071-2350
Practice Address - Country:US
Practice Address - Phone:770-446-0929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CPACS @ COSMO BUILDING B
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty