Individual
MR. RUSTIN JIN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
4000 E CHARLESTON BLVD, SUITE 130, LAS VEGAS, NV 89104-6659
(702) 968-4020
(702) 968-4040
Mailing address
4000 E CHARLESTON BLVD, SUITE 130, LAS VEGAS, NV 89104-6659
(702) 968-4020
(702) 968-4040
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN65754
NV
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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