Individual provider · Type 1 NPI
Donald Ray Jack, MD
Basic Emergency Medical Technician · Hollywood, CA
NPI number
1497079875
Active
Practice location
1644 Wilcox Ave
Hollywood, CA 90028-6206
Mailing address
180 E. Providencia Ave.
Burbank, CA 91205
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Basic Emergency Medical Technician Primary | 146N00000X | 12521464546464 (KY) |
Basic Emergency Medical Technician: A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards.
About NPI 1497079875
Donald Ray Jack, MD's National Provider Identifier is 1497079875, issued on Mar 15, 2010. The primary taxonomy on file is Basic Emergency Medical Technician (146N00000X), and the practice location is in Hollywood, CA. The record was last updated on Mar 15, 2010.