Individual
MARK C. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6345 BALBOA BLVD, BUILDING 3, SUITE 250, ENCINO, CA 91316-1519
(818) 344-3937
(818) 344-1229
Mailing address
10507 ILONA AVE, LOS ANGELES, CA 90064-2312
(310) 470-0848
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
11381T
CA
152WC0802X
Corneal and Contact Management Optometrist
Primary
11381T
CA
152WV0400X
Vision Therapy Optometrist
11381T
CA
Other
Enumeration date
03/28/2006
Last updated
09/11/2025
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