DR. JACK OSCAR PIASECKI M.D. NPI 1659416741

NPI Information

NPI: 1659416741
Provider Name: DR. JACK OSCAR PIASECKI, M.D.
Classification: Neuromusculoskeletal Medicine, Sports Medicine - 204C00000X
Entity Type: Individual
Address:
17400 IRVINE BLVD
SUITE L
TUSTIN, CA
ZIP 92780
Phone: (714) 508-1112
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DR. Jack Oscar Piasecki, M.D. is a neuromusculoskeletal medicine sports medicine in Tustin, CA. The provider is definition to come. DR. Jack Oscar Piasecki, M.D. NPI is 1659416741. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

17400 IRVINE BLVD
SUITE L
TUSTIN, CA
ZIP 92780-030
Phone: (714) 508-1112
Fax: (714) 508-3653

The enumeration date for this NPI number is 2/20/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	204C00000X	Neuromusculoskeletal Medicine, Sports Medicine		G53516	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier Issuer
1	D47810	MEDICARE UPIN
2	W19690	MEDICARE ID-TYPE UNSPECIFIED
3	WG53516A	MEDICARE ID-TYPE UNSPECIFIED	PPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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