Individual
NICOLE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-5252
(310) 423-8441
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A151614
CA
208M00000X
Hospitalist Physician
Primary
A151614
CA
Other
Enumeration date
05/24/2016
Last updated
02/28/2025
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