Individual
MR. CHE SONG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
3500 BARRANCA PKWY, SUITE 330, IRVINE, CA 92606-8226
(949) 552-8217
(949) 809-9514
Mailing address
3500 BARRANCA PKWY, SUITE 330, IRVINE, CA 92606-8226
(949) 552-8217
(949) 809-9514
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
4301031253
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280739862
BLUE CROSS BLUE SHIELD
MI
01
—
2898621
HEALTHPLUS
MI
Enumeration date
08/31/2006
Last updated
02/24/2011
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