Active NPI
Pak Podiatry Corp.
- Podiatric Clinic/Center
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatric Clinic/Center
- License
- E4251
- Legal business name
- PAK PODIATRY CORP.
- Practice address
- 1711 W Temple St
Suite #3600
Los Angeles, CA 90026-5421 - Phone
- (213) 989-0700
- Fax
- (213) 989-0703
- NPI assigned
- May 14, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sang Joon Pak, D.P.M
- Title
- Owner/President
- Phone
- (213) 989-0700
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatric Clinic/Center | 261QP1100X | E4251 | CA | Primary |
Addresses
Primary practice location
1711 W Temple St
Suite #3600
Los Angeles, CA 90026-5421
Mailing address
1711 W Temple St
Suite #3600
Los Angeles, CA 90026-5421
Phone (213) 989-0700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E4251 | Other | CA | CALIFRONIA LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
1711 W Temple St
Ste 3600
Los Angeles, CA 90026
Phone (213) 989-0700
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147564800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1232755200000",
"number": "1396796306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 W TEMPLE ST",
"address_2": "SUITE #3600",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900265421",
"telephone_number": "213-989-0700",
"fax_number": "213-989-0703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1711 W TEMPLE ST",
"address_2": "SUITE #3600",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900265421",
"telephone_number": "213-989-0700",
"fax_number": "213-989-0703"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAK PODIATRY CORP.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-14",
"last_updated": "2009-01-24",
"status": "A",
"authorized_official_last_name": "PAK",
"authorized_official_first_name": "SANG",
"authorized_official_middle_name": "JOON",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "213-989-0700",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.P.M"
},
"taxonomies": [
{
"code": "261QP1100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Podiatric",
"state": "CA",
"license": "E4251",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFRONIA LICENSE NUMBER",
"identifier": "E4251",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.