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Contact Information

SUSAN G PAK, PA
81 HIGHLAND SPRINGS AVE
SUITE 200
BEAUMONT, CA92223
 Phone: 951-845-0313
 Fax: 909-796-4158
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SUSAN G PAK · (Female)

NPI # 1366497703
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 05/24/2006
Last updated 07/21/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PA14449
  • CA Medicaid OPA144490
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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