# KENNETH K. PARK, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KENNETH K. PARK, M.D., INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1922418870
- **Legal business name:** KENNETH K. PARK, M.D., INC.
- **Authorized official:** KENNETH K PARK M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (310) 316-6190

## Contact information

- **Practice address:** 23456 HAWTHORNE BLVD, SUITE 300, TORRANCE, CA 90505-4716
- **Practice address phone:** (310) 316-6190
- **Mailing address:** 2980 N BEVERLY GLEN CIR, SUITE 100, LOS ANGELES, CA 90077-1726
- **Mailing address phone:** (310) 943-4180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | A108380 | CA | Yes |

## Other

- **Enumeration date:** 04/30/2014
- **Last updated:** 10/19/2015