Individual
BEAU YUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100A DRAKES LANDING RD, GREENBRAE, CA 94904-2438
(415) 461-7800
Mailing address
531 D ST APT C, SAN RAFAEL, CA 94901-4068
(310) 736-0394
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD461241
PA
207VG0400X
Gynecology Physician
Primary
C185568
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033491940001
—
PA
Enumeration date
04/12/2011
Last updated
08/07/2024
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