Individual
MR. PETER PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
1800 W BEVERLY BLVD STE 101, MONTEBELLO, CA 90640-3964
(323) 516-6252
(714) 801-7928
Mailing address
1800 W BEVERLY BLVD STE 101, MONTEBELLO, CA 90640-3964
(323) 516-6252
(714) 801-7928
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
DC32033
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC32033
CALIFORNIA STATE LICENCE
CA
Enumeration date
04/11/2012
Last updated
04/11/2012
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