Individual
PETER SANG-WOOK PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
8311 FLORENCE AVE, DOWNEY, CA 90240-3928
(562) 923-4911
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E4031
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4031
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E40310
MEDI CAL
CA
01
—
1104825033
NPI
CA
01
—
CE813A
MEDICARE PTAN
CA
Enumeration date
07/21/2005
Last updated
01/05/2026
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