Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Donald Ray Jack, MD

Individual provider Basic Emergency Medical Technician · NPI 1497079875

Mr. Donald Ray Jack, MD is a Basic Emergency Medical Technician in Hollywood, California. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1644 Wilcox Ave
Hollywood, CA 90028-6206
Phone: (424) 202-0322
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Basic Emergency Medical Technician (primary) Taxonomy 146N00000X · Licence 12521464546464 (KY)

Record details

NPI number1497079875
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 15, 2010
Last updated in NPPESMarch 15, 2010
Mailing address180 E. Providencia Ave., Burbank, CA 91205