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Individual
SONYA MINHA PARK
Active
Individual
SONYA MINHA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4527
MA
152W00000X
Optometrist
Primary
OPT14382-TPL
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4527
LICENSE
MA
01
—
OPT14382-TPL
CA LICENSE
CA
Enumeration date
06/14/2006
Last updated
05/04/2017
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