Organization
SAMUEL RYAN PARK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL RYAN PARK MD (CEO)
(949) 207-7650
Entity
Organization
Contact information
Practice address
22 ODYSSEY STE 155, IRVINE, CA 92618-3194
(949) 207-7650
(949) 625-6135
Mailing address
22 ODYSSEY STE 155, IRVINE, CA 92618-3194
(949) 207-7650
(949) 625-6135
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A75650
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
A75650
CA
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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