Individual
DR. THEODORE ROBERTSON PAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
291119
MA
207RI0200X
Infectious Disease Physician
291119
MA
207RI0200X
Infectious Disease Physician
Primary
A203241
CA
Other
Enumeration date
03/18/2019
Last updated
01/09/2026
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