Individual
JUN SANG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4220 W 3RD ST, LOS ANGELES, CA 90020-3450
(209) 518-2095
Mailing address
3820 BLANCHE ST, PASADENA, CA 91107-3944
(209) 518-2095
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DDS107513
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DDS107513
DENTAL BOARD OF CALIFORNIA
CA
Enumeration date
08/04/2022
Last updated
08/04/2022
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