Individual
DR. DANIEL LEE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
155 N FRESNO ST, FRESNO, CA 93701-2302
(559) 499-6500
Mailing address
155 N FRESNO ST, FRESNO, CA 93701-2302
(559) 499-6500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A22151
CA
207R00000X
Internal Medicine Physician
PTL1915
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99399523G78029
—
CA
Enumeration date
03/25/2021
Last updated
06/19/2024
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