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Mr. Donald Ray Jack, MD
Basic Emergency Medical Technician in Hollywood, California
NPI 1497079875

Donald Ray Jack is a Basic Emergency Medical Technician based in Burbank, CA. Donald Ray Jack practices in Hollywood, CA and has the professional credentials of MD. The NPI Number for Donald Ray Jack is 1497079875 and holds a License No. 12521464546464 (California).

The current practice location address for Donald Ray Jack is 1644 Wilcox Ave, Hollywood, CA and can be reached out via phone at 424-202-0322.

Location: 1644 Wilcox Ave, Hollywood, CA, 91205
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1497079875
Provider Name
Donald Ray Jack
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1644 Wilcox Ave, Hollywood, CA, 91205
Phone Number
424-202-0322
Fax Number
Provider Enumeration Date
03/15/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1644 Wilcox Ave
City
Hollywood
State
California
Zip
90028-6206
Phone Number
424-202-0322
Fax Number
person
Provider Business Mailing Address Details
Address
1644 Wilcox Ave
City
Hollywood
State
California
Zip
90028-6206
Phone Number
424-202-0322
Fax Number
person
Provider's Taxonomy Details 1
Type
Emergency Medical Service Providers
Classification
Emergency Medical Technician, Basic
Speciality
-
Taxonomy
146N00000X
License No.
12521464546464 (Kentucky)
Definition
A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards.
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