Provider Demographics
NPI:1558485508
Name:PK HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:PK HEALTHCARE SERVICES INC
Other - Org Name:ONSITE WELLNESS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANG
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-618-1988
Mailing Address - Street 1:2275 TORRANCE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-0519
Mailing Address - Country:US
Mailing Address - Phone:310-618-1988
Mailing Address - Fax:310-618-1996
Practice Address - Street 1:2275 TORRANCE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-0519
Practice Address - Country:US
Practice Address - Phone:310-618-1988
Practice Address - Fax:310-618-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0100X
CA302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No302R00000XManaged Care OrganizationsHealth Maintenance Organization