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Organization
YOONG JONG PARK MD INC
Active
Organization
YOONG JONG PARK MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOONG JONG PARK M.D. (PRESIDENT)
(661) 945-5780
Entity
Organization
Contact information
Practice address
1720 W AVENUE J, LANCASTER, CA 93534-2700
(661) 952-1100
(661) 952-1103
Mailing address
101 S 1ST ST, SUITE 1000, BURBANK, CA 91502-1938
(818) 845-6206
(818) 845-9774
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A30985
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A309850
BLUE SHIELD OF CALIFORNIA
CA
05
—
00A309850
—
CA
Enumeration date
10/13/2006
Last updated
10/15/2008
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