Stems PRP, Inc

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

STEMS PRP, INC

Practice address

626 W Commonwealth Ave
Fullerton, CA 92832-1725

Phone

(714) 389-7000

NPI assigned

Aug 14, 2024

Organization subpart

No

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

Authorized official

Name

Jaewoo Pak, MDNPI 1962567321

Title

Ceo

Phone

(714) 389-7000

Specialties & licenses 1

Addresses

Other names 1

• Stems Pain Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Stems PRP, Inc

  • Pain Clinic/Center
  • Fullerton, CA
  • NPI 1083283741

  O20210630001152

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaewoo Pak, M.D.

  • Pain Medicine Physician
  • Irvine, CA
  • NPI 1962567321
  NPD Authorized official

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1861224339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321725",
            "telephone_number": "714-389-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 W COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321725",
            "telephone_number": "714-389-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEMS PRP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "JAEWOO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-389-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stems Pain Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Steele, PSY.D.
• Stephanie Lynn Stefanelli, PSY. D
• Benjamin Stein
• Stela Dimitrova-Munro, D.D.S., Inc.
• Stems PRP, Inc
• Marisela Stephens
• Melanie Marie Stern, SUDRC
• Steve Kim Chiropractic, Inc.
• Steven a Miyamoto, DDS, Inc.
• Steven H Yu DDS Inc

• Pain Clinic/Center in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Pain Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.

Verify at the official NPI Registry.