# WOORI MEDICAL GROUP PROFESSIONAL CORP

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

## Provider details

- **NPI number:** 1275764706
- **Authorized official:** DR. RO JONG PARK M.D. (PRESIDENT)
- **Authorized official phone:** (858) 277-7111

## Contact information

- **Practice address:** 7825 ENGINEER RD, STE 101, SAN DIEGO, CA 92111-1924
- **Practice address phone:** (858) 277-7111
- **Practice address fax:** (858) 277-7667
- **Mailing address:** 7825 ENGINEER RD, STE 101, SAN DIEGO, CA 92111-1924
- **Mailing address phone:** (858) 277-7111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | C51444 | CA | — |
| 208D00000X | General Practice Physician | C51913 | CA | Yes |

## Other

- **Enumeration date:** 07/31/2009
- **Last updated:** 03/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1275764706 | — | CA |