Individual
MR. DANIEL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1441 EASTLAKE AVE, STE 7416, LOS ANGELES, CA 90089-2211
(323) 865-3700
(323) 865-0120
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 865-3700
(323) 865-0120
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13945
CA
363AM0700X
Medical Physician Assistant
PA13945
CA
363AS0400X
Surgical Physician Assistant
PA13945
CA
Other
Enumeration date
05/23/2005
Last updated
02/03/2023
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