Individual
SAMUEL MO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
340 W EAST AVE, CHICO, CA 95926-7238
(530) 342-2777
(530) 342-2776
Mailing address
236 W EAST AVE STE A, PMB 253, CHICO, CA 95926-7236
(530) 342-2777
(530) 342-2776
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
35076716P
OH
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G87601
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3697637
—
CA
Enumeration date
06/15/2005
Last updated
12/15/2021
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