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Organization

PAK PODIATRY CORP.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SANG(JAMES) JOON PAK D.P.M (OWNER)
(818) 782-0411
Entity
Organization

Contact information

Practice address
6817 BALBOA BLVD, #B, VAN NUYS, CA 91406-4543
(818) 782-0411
(818) 782-0532
Mailing address
6817 BALBOA BLVD, #B, VAN NUYS, CA 91406-4543
(818) 782-0411
(818) 782-0532

Taxonomy

Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
E4251
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E4251
STATE LICENSE NUMBER
CA
Enumeration date
02/27/2007
Last updated
11/08/2007
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