| West Oak Lane Medical Center | |
|
1738 W Cheltenham Ave Philadelphia PA 19126-1546 | |
| (215) 548-3390 | |
| (215) 549-8998 |
| Full Name | West Oak Lane Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1738 W Cheltenham Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | John J Bowden (CEO) |
| Authorized Official Contact | 2155483403 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Oak Lane Medical Center 1738 W Cheltenham Ave Philadelphia PA 19126-1546 Ph: (215) 548-3390 | West Oak Lane Medical Center 1738 W Cheltenham Ave Philadelphia PA 19126-1546 Ph: (215) 548-3390 |
| NPI Number | 1467461806 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 10/16/2015 |
| Medicare PECOS PAC ID | 9234207119 |
|---|---|
| Medicare Enrollment ID | O20081006000068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467461806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | John J Bowden |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1447200258 PECOS PAC ID: 0941378129 Enrollment ID: I20081002000014 |
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