| Organization Name: | CALIFORNIA UNIVERSITY OF PENNSYLVANIA |
| NPI Number: | 1003168162 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FRANCES DUDA FAYISH (NURSE PRACTITIONER) |
| Mailing Address: | 250 University Ave California |
| State: | PA US |
| Postal Code: | 154191341 |
| Phone Number: | 7249385922 |
| Fax Number: | 7249384509 |
| NPI Enumeration Date: | 10/12/2012 |
| NPI Last Update Date: | 10/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | VP006076B |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |