| Stems Prp, Inc | |
|
626 W Commonwealth Ave Fullerton CA 92832-1725 | |
| (714) 389-7000 | |
| Not Available |
| Full Name | Stems Prp, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 626 W Commonwealth Ave, Fullerton, California |
| Authorized Official Name and Position | Jaewoo Pak (CEO) |
| Authorized Official Contact | 7143897000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stems Prp, Inc 626 W Commonwealth Ave Fullerton CA 92832-1725 Ph: (714) 389-7000 | Stems Prp, Inc 626 W Commonwealth Ave Fullerton CA 92832-1725 Ph: (714) 389-7000 |
| NPI Number | 1083283741 |
|---|---|
| Provider Enumeration Date | 06/17/2021 |
| Last Update Date | 12/19/2024 |
| Medicare PECOS PAC ID | 5890196620 |
|---|---|
| Medicare Enrollment ID | O20210630001152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083283741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QP3300X | Clinic/center - Pain | (* (Not Available)) | Primary |
| Provider Name | Jaewoo Pak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962567321 PECOS PAC ID: 7214992965 Enrollment ID: I20041122001301 |
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