Dr. Jaesoo Pak
Gastroenterologist
11841 South St
Cerritos
, California 90703-6825
Dr. Jaesoo Pak
Gastroenterologist
11841 South St
Cerritos
, California 90703-6825
(562) 809-8082
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About
Features
Specialties
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Jaesoo Pak
- 11841 South St
- Cerritos, CA
- Zip : 90703-6825
- Phone : (562) 809-8082
Second Address
- Dr. Jaesoo Pak
- 11841 South St
- Cerritos, CA
- Zip : 90703-6825
- Phone : (562) 809-8082
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0100X | Gastroenterologist | G77845 | CA |
National Provider Identifier
| NPI | 1023124054 |
|---|---|
| Provider Name | Dr. Jaesoo Pak |
| First Address | Cerritos, CA 90703-6825 |
| Second Address | Cerritos, CA 90703-6825 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/08/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G077845 | (05) | CA |
| G03232 | (02) | CA |
| G77845 | MEDICAL LICENSE NUMBER (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.