Individual
RENEE E PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-5000
Mailing address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(877) 608-0044
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
A135401
CA
207YP0228X
Pediatric Otolaryngology Physician
MD454696
PA
Other
Enumeration date
04/10/2009
Last updated
11/29/2021
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