Individual
DR. JI-KWAN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
1721 TECHNOLOGY DR DEPT 110, SAN JOSE, CA 95110-1305
(408) 436-1000
Mailing address
1721 TECHNOLOGY DR DEPT 110, SAN JOSE, CA 95110-1305
(408) 436-3350
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A155176
CA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
01084888A
IN
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
A155176
CA
Other
Enumeration date
04/26/2016
Last updated
08/14/2023
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