Individual
DR. DAVID L PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D., M.S.
Contact information
Practice address
102 SCOTT ST, UKIAH, CA 95482-4316
(707) 462-7040
(707) 462-7089
Mailing address
102 SCOTT ST, UKIAH, CA 95482-4316
(707) 462-7040
(707) 462-7089
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT7782T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0077820
—
CA
Enumeration date
09/30/2005
Last updated
03/15/2012
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