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Individual
JAE CHANG PARK
Active
Individual
JAE CHANG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.C.
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 10209
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC 10209
ACUPUNTURIST
CA
Enumeration date
03/12/2007
Last updated
01/26/2023
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