Organization
MIN S. PARK, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIN S PARK M.D. (PRESIDENT)
(213) 382-0031
Entity
Organization
Contact information
Practice address
2675 W OLYMPIC BLVD, SUITE 100, LOS ANGELES, CA 90006-2880
(213) 382-0031
(213) 480-0463
Mailing address
4735 GOULD AVE, LA CANADA FLINTRIDGE, CA 91011-2629
(213) 382-0031
(213) 480-0463
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G78220
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W18581
MEDICARE GROUP ID
CA
Enumeration date
07/31/2007
Last updated
06/26/2012
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