Su Yong Pak,M.D. Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A34079 Issued in CA

Legal business name

SU YONG PAK,M.D. INC

Practice address

5451 La Palma Ave
14
La Palma, CA 90623-1728

Phone

(714) 523-3212

NPI assigned

Nov 21, 2006

Last updated

Feb 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Su Yong Pak, M.D.

Title

M.D.

Phone

(714) 523-3212

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Su Yong Pak, M.D.

  • Internal Medicine Physician
  • Lynnwood, WA
  • NPI 1437169372

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1942375506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5451 LA PALMA AVE",
            "address_2": "14",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231728",
            "telephone_number": "714-523-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 LA PALMA AVE",
            "address_2": "14",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231728",
            "telephone_number": "714-523-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SU YONG PAK,M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "SU",
        "authorized_official_middle_name": "YONG",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "714-523-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A34079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aglae Sotomayor Rubio
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• Jodi Lynn Stephens, AU.D.
• Ashley Rochelle Stone
• Nathan Suaste
• Emily Summers
• Peter Justin Garcia Taguinod, DPT
• Kwan Toh Tan, M.D.
• Regina Mallari Tan, DDS

• Gastroenterology Physician in La Palma, CA
• Providers in La Palma, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.