Provider Demographics
NPI:1841404837
Name:UNION OF PAN ASIAN COMMUNITIES
Entity Type:Organization
Organization Name:UNION OF PAN ASIAN COMMUNITIES
Other - Org Name:UPAC EAST WIND CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:IWANAGA
Authorized Official - Last Name:PENROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-232-6454
Mailing Address - Street 1:1031 25TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-2102
Mailing Address - Country:US
Mailing Address - Phone:619-232-6454
Mailing Address - Fax:
Practice Address - Street 1:8745 AERO DR
Practice Address - Street 2:STE. 330
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1761
Practice Address - Country:US
Practice Address - Phone:858-268-4933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION OF PAN ASIAN COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-09
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACH345AOtherMEDICARE PROVIDER TRANSACTION ACCESS NUMBER