Organization
ROBERT PARK M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT PARK M.D. (OWNER)
(707) 765-1501
Entity
Organization
Contact information
Practice address
191 LYNCH CREEK WAY, SUITE 205, PETALUMA, CA 94954-2389
(707) 765-1501
(707) 765-1530
Mailing address
191 LYNCH CREEK WAY, SUITE 205, PETALUMA, CA 94954-2389
(707) 765-1501
(707) 765-1530
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G22984
CA
Other
Enumeration date
09/27/2007
Last updated
10/10/2007
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