NPIMap

Organization Active NPI

Paks Medical Clinic, Inc

  • Medical Specialty Clinic/Center
  • Cerritos, CA
National Provider Identifier
1497975833
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
G077617 Issued in CA
Legal business name
PAKS MEDICAL CLINIC, INC
Practice address
11839 South St.
Cerritos, CA 90703-6825
Phone
(562) 809-8830
Fax
(562) 809-3893
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jaewoo Pak, M.D.NPI 1962567321
Title
President
Phone
(562) 809-8830

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)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X G077617 CA Primary

Addresses

Primary practice location

11839 South St.
Cerritos, CA 90703-6825

Mailing address

11839 South St.
Cerritos, CA 90703-6825
Phone (562) 809-8830

National Provider Directory

National Provider Directory

Locations

11839 South St
Cerritos, CA 90703
Phone (562) 809-8830

Practitioners & affiliated clinicians

Practitioners 2

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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497975833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11839 SOUTH ST.",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036825",
            "telephone_number": "562-809-8830",
            "fax_number": "562-809-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11839 SOUTH ST.",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036825",
            "telephone_number": "562-809-8830",
            "fax_number": "562-809-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAKS MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "JAEWOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-809-8830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G077617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.