Organization
BACK TO WORK ORTHOPEDIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PARK (MD)
(562) 633-2273
Entity
Organization
Contact information
Practice address
5203 LAKEWOOD BLVD, LAKEWOOD, CA 90712-2438
(562) 633-2273
Mailing address
5203 LAKEWOOD BLVD, LAKEWOOD, CA 90712-2438
(562) 633-2273
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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