Individual
DR. JOHN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 359-8111
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A85814
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A858140
—
CA
Enumeration date
02/28/2007
Last updated
11/19/2020
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