Organization
SAMUEL PARK MD A MEDICAL CORPORATION
Active
Other names
Odyssey Pain Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL RYAN PARK MD (PRESIDENT)
(949) 207-7650
Entity
Organization
Contact information
Practice address
22 ODYSSEY STE 155, IRVINE, CA 92618-3194
(949) 207-7650
Mailing address
22 ODYSSEY STE 155, IRVINE, CA 92618-3194
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A75650
CA
Other
Enumeration date
07/27/2012
Last updated
12/30/2012
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