Organization
SOUTH BAYLO UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PARK (PRESIDENT)
(714) 533-1495
Entity
Organization
Contact information
Practice address
1126 N BROOKHURST ST, 3RD FLOOR, ANAHEIM, CA 92801-1702
(714) 535-3886
(714) 535-3919
Mailing address
1126 N BROOKHURST ST, 3RD FLOOR, ANAHEIM, CA 92801-1702
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
AC4649
CA
Other
Enumeration date
01/19/2007
Last updated
08/22/2020
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