Individual
PAUL W. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3055 WILSHIRE BLVD STE 100, LOS ANGELES, CA 90010-1119
(213) 484-1000
Mailing address
2 COLUMBUS AVE APT 23B, NEW YORK, NY 10023-6921
(713) 385-0618
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A91067
CA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
25MA11319300
NJ
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
313820-01
NY
Other
Enumeration date
04/26/2006
Last updated
03/02/2024
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