Organization
G2J CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MI RAN PARK M.D. (MEDICAL DIRECTOR)
(408) 293-0800
Entity
Organization
Contact information
Practice address
5150 GRAVES AVE, SUITE 11B, SAN JOSE, CA 95129-5013
(408) 293-0800
Mailing address
5150 GRAVES AVE, SUITE 11B, SAN JOSE, CA 95129-5013
(408) 293-0800
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A103558
CA
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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