Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DONALD RAY JACK, M.D.
Active Sole ProprietorMR. DONALD RAY JACK, M.D. is a Emergency Medical Technician, Basic healthcare provider located in HOLLYWOOD, California. NPI 1497079875 is currently active in the NPPES registry. Verify at CMS.
Emergency Medical Technician, Basic · HOLLYWOOD, CA
Registration Details
- NPI Number
- 1497079875
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 15, 2010 (16.44451198955 yrs)
- Last Updated
- Mar 15, 2010
- License
-
12521464546464 (KY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1644 WILCOX AVEHOLLYWOOD, CA, 900286206Browse CA providers · Browse ZIP 90028
- Phone
- 4242020322
- Primary Specialty
-
Emergency Medical Technician, Basic
146N00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.