Individual
TONY JUNGWOO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7212 ORANGETHORPE AVE STE 9A, BUENA PARK, CA 90621-4668
(714) 503-6550
(714) 409-3075
Mailing address
53 SCARLET BLOOM, IRVINE, CA 92618-8808
(858) 740-4142
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
835101
CA
363LF0000X
Family Nurse Practitioner
95003723
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2020011541
CA
Other
Enumeration date
01/14/2016
Last updated
11/04/2024
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