Individual
DR. KITAE KEVIN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2251 W ROSECRANS AVE STE 21, COMPTON, CA 90222-3860
(424) 529-6755
Mailing address
PO BOX 845833, LOS ANGELES, CA 90084-5833
(310) 792-3914
(855) 898-4055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C56093
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
16037
HI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
C56093
CA
207RP1001X
Pulmonary Disease Physician
16037
HI
207RP1001X
Pulmonary Disease Physician
Primary
C56093
CA
Other
Enumeration date
01/10/2008
Last updated
03/17/2018
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