Organization
RICHARD PARK MEDICAL GROUP APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD PARK MD (OWNER/MEDICAL DIRECTOR)
(818) 850-2960
Entity
Organization
Contact information
Practice address
7535 LAUREL CANYON BLVD, NORTH HOLLYWOOD, CA 91605-3149
(818) 850-2960
(818) 747-2800
Mailing address
7535 LAUREL CANYON BLVD, NORTH HOLLYWOOD, CA 91605-3149
(818) 850-2960
(818) 747-2800
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A111560
MEDICAL LICENSE
CA
Enumeration date
10/06/2020
Last updated
10/06/2020
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