Provider Demographics
NPI:1871677724
Name:PINSKY, DAVID DREW (MD,)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:DREW
Last Name:PINSKY
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:PINSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1050 BEVERLY WAY
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2516
Mailing Address - Country:US
Mailing Address - Phone:626-799-4151
Mailing Address - Fax:626-799-4207
Practice Address - Street 1:2050 HUNTINGTON DR
Practice Address - Street 2:SUITE D
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4900
Practice Address - Country:US
Practice Address - Phone:626-799-4151
Practice Address - Fax:626-799-4207
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55092207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B57975Medicare UPIN
G55092Medicare ID - Type Unspecified