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Individual

BRIAN YOUNGJAE PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
326 SANTA FE DR, ENCINITAS, CA 92024-5156
(760) 633-7260
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(760) 633-7260

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
207Q00000X
Family Medicine Physician
Primary
20A20862
CA
207Q00000X
Family Medicine Physician
60462-21
WI

Other

Enumeration date
05/02/2011
Last updated
06/09/2023
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