MR. DONALD RAY JACK M.D.
NPI 1497079875
Emergency Medical Technician, Basic in Hollywood, CA

Q: What is Donald Jack's NPI number?

The NPI number for Donald Jack is 1497079875. It was assigned to this individual provider in the NPPES registry on March 15, 2010.

Q: What is Donald Jack's specialty?

The primary specialty registered for this NPI is Emergency Medical Technician, Basic with taxonomy code 146N00000X.

Q: When was this NPI record last updated?

The NPPES record for Donald Jack was last updated on March 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 15, 2010

1644 WILCOX AVE, HOLLYWOOD, CA 90028(424) 202-0322 Get Directions Write a Review

NPPES record last updated: March 15, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Donald Ray Jack M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DONALD RAY JACK M.D. (NPI 1497079875) is an individual emergency medical technician, basic provider in Hollywood, California, licensed in Kentucky (12521464546464) and active in the NPI registry since March 2010.

NPPES Registry Identity

NPI1497079875

Entity TypeIndividualMale

Primary Taxonomy146N00000X

Provider Legal NameMR. DONALD RAY JACKCredential: M.D.

Location Address1644 WILCOX AVEHollywood, CA 90028-6206

Mailing Address180 E. Providencia Ave.Burbank, CA 91205 · (424) 202-0322

Phone(424) 202-0322

Sole ProprietorYes

Enumeration DateMarch 15, 2010

✔ NPI 1497079875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medical Technician, BasicEmergency Medical Service Providers

Taxonomy Code146N00000X

License✔ Licensed in KY · 12521464546464

Definition

A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards.

1644 WILCOX AVE, Hollywood, CA 90028

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Donald Jack's NPI number?

The NPI number for Donald Jack is 1497079875. It was assigned to this individual provider in the NPPES registry on March 15, 2010.

Where is Donald Jack located?

Donald Jack practices at 1644 Wilcox Ave, Hollywood, CA 90028. The listed phone number is (424) 202-0322.

What is Donald Jack's specialty?

The primary specialty registered for this NPI is Emergency Medical Technician, Basic with taxonomy code 146N00000X.

When was this NPI record last updated?

The NPPES record for Donald Jack was last updated on March 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.