PAKS MEDICAL CLINIC, INC (NPI# 1497975833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497975833 |
| Entity Type | Organization |
| Organization Name | PAKS MEDICAL CLINIC, INC |
| Practice Address |
11839 South St. Cerritos CA 90703-6825 |
| Practice Telephone | 5628098830 |
| Practice Fax Number | 5628093893 |
| Mailing Telephone | 5628098830 |
| Mailing Fax Number | 5628093893 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JAEWOO PAK (PRESIDENT) |
| Authorized Official Telephone | 5628098830 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
G077617 | CA | Ambulatory Health Care Facilities |
| Street Address |
11839 SOUTH ST. |
| City | CERRITOS |
| State | CA |
| Zip Code | 90703-6825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909582 | Michael Wong Dental Corporation | Dentist | 11549 South Street, Cerritos, CA 90703 | 2020-10-15 |
| 1144837139 | Essential California Ipa Inc. | Health Maintenance Organization | 1800 Studebaker Rd., 100, Cerritos, CA 90703 | 2020-09-24 |
| 1447868377 | Auxilium Health Network, Inc. | Health Maintenance Organization | 18000 Studebaker Dr, Cerritos, CA 90703 | 2020-07-16 |
| 1154939098 | Absolute Medical Partners, A Professional Medical Corporation | Health Maintenance Organization | 18000 Studebaker Rd., Ste 100, Cerritos, CA 90703 | 2020-07-16 |
| 1558906487 | Vitruvian Care, Inc. | Health Maintenance Organization | 18000 Studebaker Road Suite 100, Cerritos, CA 90703 | 2019-11-14 |
| 1841843554 | Ha Tran Tsai Dental Corporation | Dentist | 16466 Norwalk Boulevard, Cerritos, CA 90703 | 2019-07-22 |
| 1457828097 | Angela Ofoegbu | Registered Nurse | 10733 Elgers St, Cerritos, CA 90703 | 2018-11-01 |
| 1689183352 | Zeela G Diwa | Occupational Therapist | 12736 Palm Street, Cerritos, CA 90703 | 2017-09-26 |
| 1114446119 | Cooper Lee | Physical Therapist | 18503 Noran Ave, Cerritos, CA 90703 | 2017-09-12 |
| 1295259141 | Miyeon Vivienne Lee | Nurse Practitioner | 13337 South Street #158, Cerritos, CA 90703 | 2017-08-02 |
| Find all providers in zip 90703 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.