Individual
CHAN HO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4721 OAKWOOD AVE, LOS ANGELES, CA 90004-3112
(206) 660-7988
Mailing address
4721 OAKWOOD AVE, LOS ANGELES, CA 90004-3112
(206) 660-7988
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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