Individual
RAYMOND PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O,
Contact information
Practice address
4733 W SUNSET BLVD, 3RD FLOOR, LOS ANGELES, CA 90027-6021
(323) 783-1338
Mailing address
4733 W SUNSET BLVD, 3RD FLOOR, LOS ANGELES, CA 90027-6021
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
8XGL620
CA
Other
Enumeration date
05/16/2016
Last updated
03/13/2024
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