# RICHARD PARK, MD A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063332534
- **Authorized official:** CHELSEA EMBER (DIRECTOR)
- **Authorized official phone:** (615) 522-4079

## Contact information

- **Practice address:** 10515 BALBOA BLVD STE 325, GRANADA HILLS, CA 91344-6364
- **Practice address phone:** (805) 368-1293
- **Mailing address:** 10515 BALBOA BLVD STE 325, GRANADA HILLS, CA 91344-6364
- **Mailing address phone:** (805) 368-1293

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2026
- **Last updated:** 07/16/2026