Individual
BILLIE K PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4300 ROSE DR, YORBA LINDA, CA 92886-2026
(714) 577-6680
(714) 579-6864
Mailing address
4300 ROSE DR, YORBA LINDA, CA 92886-2026
(714) 577-6680
(714) 579-6864
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A 10656
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A10656
OSTEOPATHIC MEDICAL BOARD
CA
Enumeration date
08/21/2007
Last updated
11/09/2021
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