Active NPI
Susan Pak, M.D.
- Child & Adolescent Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1891993267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- A90686
- Practice address
- 4701 E Cesar E Chavez Ave FL 2
Los Angeles, CA 90022-1209 - Phone
- (323) 267-3400
- Fax
- (323) 260-5201
- NPI assigned
- Jul 6, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | A90686 | CA | Primary |
Addresses
Primary practice location
4701 E Cesar E Chavez Ave FL 2
Los Angeles, CA 90022-1209
Mailing address
4701 E Cesar E Chavez Ave FL 2
Los Angeles, CA 90022-1209
Phone (323) 267-3400
Other practice location 1
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-2450
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1891993267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4701 E CESAR E CHAVEZ AVE FL 2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900221209",
"telephone_number": "323-267-3400",
"fax_number": "323-260-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 E CESAR E CHAVEZ AVE FL 2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900221209",
"telephone_number": "323-267-3400",
"fax_number": "323-260-5201"
}
],
"practiceLocations": [
{
"address_1": "4650 W Sunset Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900276062",
"country_code": "US",
"telephone_number": "323-361-2450",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAK",
"first_name": "SUSAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-06",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "A90686",
"primary": true
}
],
"identifiers": [],
"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 May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.