Individual
DR. PAUL J PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 MILL ST MS W14, RENO, NV 89502-1576
(775) 982-7878
(775) 982-4196
Mailing address
1155 MILL ST MS M14, RENO, NV 89502-1576
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20512
NV
207R00000X
Internal Medicine Physician
7942612-1205
UT
208600000X
Surgery Physician
49828
MN
208600000X
Surgery Physician
7942612-1205
UT
208M00000X
Hospitalist Physician
Primary
20512
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381602000
—
MN
Enumeration date
04/02/2007
Last updated
11/25/2020
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