Individual
AMY KANGME PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11406 LOMA LINDA DR, LOMA LINDA, CA 92354-3711
(909) 558-6277
Mailing address
11406 LOMA LINDA DR, LOMA LINDA, CA 92354-3711
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
20011
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2018
Last updated
04/18/2023
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