Individual
DR. CHANSU PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC,. PHD
Contact information
Practice address
3053 W OLYMPIC BLVD STE 311, LOS ANGELES, CA 90006-2558
(213) 384-4589
(213) 365-0167
Mailing address
3053 W. OLYMPIC BL #311, LOS ANGELES, CA 90006
(213) 384-4589
(213) 365-0167
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 12191
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC 12191
ACUPUNCTURIST
CA
Enumeration date
03/09/2010
Last updated
02/13/2015
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