Provider Demographics
NPI:1891795118
Name:PAK, JOHN C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:PAK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1269 SUMMERSWORTH PL
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-2054
Mailing Address - Country:US
Mailing Address - Phone:714-879-4778
Mailing Address - Fax:714-879-4767
Practice Address - Street 1:1269 SUMMERSWORTH PL
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-2054
Practice Address - Country:US
Practice Address - Phone:714-879-4778
Practice Address - Fax:714-879-4767
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARPH 443991835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy