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Individual
YANGSEON PARK
Active
Individual
YANGSEON PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MT210086
PA
207L00000X
Anesthesiology Physician
Primary
T2946
TX
208600000X
Surgery Physician
0101255025
VA
208600000X
Surgery Physician
278193
NY
208600000X
Surgery Physician
MD455479
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/20/2011
Last updated
12/09/2021
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