Active NPI
Min-Ung Pak, MD
- Anesthesiology Physician
- Norwalk, CA
National Provider Identifier
1104862143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A39967
- Practice address
- 13100 Studebaker Rd
Norwalk, CA 90650 - Phone
- (562) 868-3751
- Fax
- (562) 929-3582
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A39967 | CA | Primary |
Addresses
Primary practice location
13100 Studebaker Rd
Norwalk, CA 90650
Mailing address
PO Box 7096
Stockton, CA 95267
Phone (209) 956-7725
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A399670 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A39967 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262044800000",
"number": "1104862143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7096",
"city": "STOCKTON",
"state": "CA",
"postal_code": "95267",
"telephone_number": "209-956-7725",
"fax_number": "209-956-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13100 STUDEBAKER RD",
"city": "NORWALK",
"state": "CA",
"postal_code": "90650",
"telephone_number": "562-868-3751",
"fax_number": "562-929-3582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAK",
"first_name": "MIN-UNG",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2009-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A39967",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A399670",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.