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Organization
OPTIMUM MEDICAL CLINICS INC
Active
Organization
OPTIMUM MEDICAL CLINICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL KYUNG-UK PARK MD (MEDICAL DIRECTOR)
(949) 757-1150
Entity
Organization
Contact information
Practice address
20072 SW BIRCH ST, STE 100, NEWPORT BEACH, CA 92660-0794
(949) 757-1150
(949) 757-1170
Mailing address
20072 SW BIRCH ST, STE 100, NEWPORT BEACH, CA 92660-0794
(949) 757-1150
(949) 757-1170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A050474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0088240
—
CA
Enumeration date
10/25/2006
Last updated
08/22/2020
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