Individual
JUN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4150 V STREET, PSSB, SUITE G400, SACRAMENTO, CA 95817
(916) 734-8328
(651) 333-4227
Mailing address
8414 NAAB RD, INDIANAPOLIS, IN 46260-1972
(317) 338-7510
(317) 733-7539
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A169512
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A169512
CALIFORNIA STATE MEDICAL LICENSE NUMBER
CA
Enumeration date
04/13/2017
Last updated
12/07/2022
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