Individual
CAROLINE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1411
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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