Jin W Pak, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC31699 Issued in CA

Practice address

1610 Oak Park Blvd
2
Pleasant Hill, CA 94523-4489

Phone

(925) 943-2222

Fax

(925) 943-2221

NPI assigned

Oct 8, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Celestial Management Inc

  • Chiropractor
  • Pleasant Hill, CA
  • NPI 1053492942
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1144530130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15550 ROCKFIELD BLVD",
            "address_2": "B220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182720",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 OAK PARK BLVD",
            "address_2": "2",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945234489",
            "telephone_number": "925-943-2222",
            "fax_number": "925-943-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "JIN",
        "middle_name": "W",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D.C. LICENSE",
            "identifier": "DC31699",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ayse Berivan Ozlu
• Christina Yvette Padilla
• Pain Medicine Consultants
• Pain Medicine Consultants, Inc.
• Pain Medicine Consultants, Inc.
• Jonathan Palarca
• Palliative Care of the East Bay
• Hope Isabella Brown Pangilinan, MS, PPS
• Leslie Ann Patka Pappin, LMFT
• Sangmi Park, D.D.S.

• Chiropractor in Pleasant Hill, CA
• Providers in Pleasant Hill, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.