Individual
DR. CHANWANG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 FIVEPOINT, IRVINE, CA 92618-2377
(949) 671-4673
(949) 671-4329
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01073853A
IN
207L00000X
Anesthesiology Physician
Primary
C170507
CA
390200000X
Student in an Organized Health Care Education/Training Program
11015365A
IN
Other
Enumeration date
06/09/2010
Last updated
12/07/2022
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