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Individual

EDWARD J PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3771 KATELLA AVE STE 210, LOS ALAMITOS, CA 90720-3118
(562) 430-0581
(562) 598-2110
Mailing address
3771 KATELLA AVE STE 210, LOS ALAMITOS, CA 90720-3118
(562) 430-0581
(562) 598-2110

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
20A17227
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
10/17/2012
Last updated
05/07/2024
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