Individual
STEPHEN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 SULLIVAN AVE, DALY CITY, CA 94015-2200
(650) 991-0600
(650) 991-0306
Mailing address
418 VIRGINIA AVE, SAN MATEO, CA 94402-2236
(650) 455-4937
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
G55543
CA
Other
Enumeration date
07/07/2006
Last updated
03/24/2015
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