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Organization
BAY AREA COMPREHENSIVE SPINE AND SPORTS MEDICAL GROUP INC
Active
Organization
BAY AREA COMPREHENSIVE SPINE AND SPORTS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL KWANSUP PARK (PRESIDENT)
(510) 463-4700
Entity
Organization
Contact information
Practice address
5700 TELEGRAPH AVE STE 100, OAKLAND, CA 94609-1710
(510) 463-4700
(510) 463-4722
Mailing address
5700 TELEGRAPH AVE STE 100, OAKLAND, CA 94609-1710
(510) 463-4700
(510) 463-4722
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
09/29/2006
Last updated
10/09/2019
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