Individual
DR. JUNG WON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C56214
CA
208000000X
Pediatrics Physician
G9781
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118238804
—
TX
01
—
89C759
BCBS
TX
01
—
P01758328-DV5277
RR MEDICARE
CA
Enumeration date
03/09/2007
Last updated
02/07/2017
Update your record
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