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Individual

KIWON PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
111 W VALENCIA DR, FULLERTON, CA 92832-2317
(858) 717-2545
Mailing address
111 W VALENCIA DR, FULLERTON, CA 92832-2317
(858) 717-2545

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95036452
CA

Other

Enumeration date
08/05/2025
Last updated
08/07/2025
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