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NPI Code Detail

MEDICARE: JE PAK

MEDICARE: JE PAK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist70731CA

General Provider Information

NPI Number : 1528460763
Entity Type Code : Individual
Provider Name (Legal Business Name) : JE PAK
Provider Business Mailing Address
First Line : 5821 ANTELOPE RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95842-3902
Country : US
Telephone Number : 916-729-6236
Fax Number :
Provider Business Practice Location Address
First Line : 5821 ANTELOPE RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95842-3902
Country : US
Telephone Number : 916-729-6236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2014
Last Update Date : 09/18/2014

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Directions to “ JE PAK ” Practice Location

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