Provider Demographics
NPI:1336305267
Name:ABC PEDIATRICS
Entity Type:Organization
Organization Name:ABC PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WOO
Authorized Official - Middle Name:H
Authorized Official - Last Name:PAEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-291-3228
Mailing Address - Street 1:3663 W 6TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3050
Mailing Address - Country:US
Mailing Address - Phone:213-291-3228
Mailing Address - Fax:213-596-8848
Practice Address - Street 1:3663 W 6TH ST STE 301
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3050
Practice Address - Country:US
Practice Address - Phone:213-291-3228
Practice Address - Fax:213-596-8848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95866208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty