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Individual

THOMAS CHIN PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2725 CAPITOL AVE, SUITE 402, SACRAMENTO, CA 95816-6004
(916) 262-9400
(916) 262-9399
Mailing address
10470 OLD PLACERVILLE RD, SUITE100, SACRAMENTO, CA 95827-2539
(800) 470-0071

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
G68104
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G681041
CA
01
770003054
RAILROAD MEDICARE
CA
Enumeration date
09/22/2006
Last updated
05/18/2015
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