Individual
JENNIFER YOON GAAHEE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11900 SOUTH ST, CERRITOS, CA 90703-6847
(888) 227-3312
Mailing address
1802 RAINBOW TERRACE LN, MONTEBELLO, CA 90640-1951
(323) 566-4111
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18765
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA18765
CONSUMER AFFAIRS-CA
CA
Enumeration date
12/01/2008
Last updated
06/24/2021
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