Healthcare Provider Details

I. General information

NPI: 1457609778
Provider Name (Legal Business Name): JEANNIE PAIK PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12254 BELLFLOWER BLVD
DOWNEY CA
90242-2804
US

IV. Provider business mailing address

12254 BELLFLOWER BLVD
DOWNEY CA
90242-2804
US

V. Phone/Fax

Practice location:
  • Phone: 562-658-4150
  • Fax:
Mailing address:
  • Phone: 562-658-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 54012
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: