Individual
DR. JUNG WON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7215 55TH ST, SACRAMENTO, CA 95823-2601
(916) 399-1100
(877) 860-2397
Mailing address
200 OCEANGATE, SUITE 100, LONG BEACH, CA 90802-4317
(562) 499-6191
(877) 860-2397
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
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