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

Richard Anthony Jack, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1306289129

Richard Anthony Jack, MD is a Student in an Organized Health Care Education/Training Program in Tarzana, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2013
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

18321 Clark St
Tarzana, CA 91356-3501
Phone: (818) 708-5570
Fax: (818) 708-5471
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 500 University Dr, Hershey, PA 17033-2360 — (917) 405-2405

Specialties & licences

Neonatal-Perinatal Medicine Physician (primary) Taxonomy 2080N0001X · Licence C175889 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1306289129
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 10, 2013
Last updated in NPPESDecember 28, 2022
Certification dateDecember 28, 2022
Mailing address4140 W 190th St, Torrance, CA 90504-5513

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