Provider Demographics
NPI:1053506527
Name:PAIK, BRIAN JOONGKEVN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOONGKEVN
Last Name:PAIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:510 SUPERIOR AVE
Mailing Address - Street 2:STE 200B
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3663
Mailing Address - Country:US
Mailing Address - Phone:949-791-3001
Mailing Address - Fax:
Practice Address - Street 1:4900 BARRANCA PKWY
Practice Address - Street 2:STE 103
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8603
Practice Address - Country:US
Practice Address - Phone:949-791-3103
Practice Address - Fax:949-791-3114
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2013-06-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA74739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HC900ZMedicare PIN