Individual
BRIAN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
DILOREZNO TRICARE HEALTH CLINIC, FEDERAL BUILDING 2, RM 1345, WASHINGTON, DC 20370-0001
(703) 614-2726
(703) 614-1593
Mailing address
18436 ROSCOE BLVD, NORTHRIDGE, CA 91325-4107
(855) 504-4544
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C54964
CA
Other
Enumeration date
10/13/2006
Last updated
11/18/2021
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