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Organization
BACK TO WORK ORTHOPEDIC MEDICAL GROUP
Active
Organization
BACK TO WORK ORTHOPEDIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN PARK MD (MD)
(562) 531-8300
Entity
Organization
Contact information
Practice address
7300 ALONDRA BLVD STE 101, PARAMOUNT, CA 90723-4000
(562) 531-8300
Mailing address
5203 LAKEWOOD BLVD, LAKEWOOD, CA 90712-2438
(562) 633-2273
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
A67778
CA
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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