Individual
DR. DEREK PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Contact information
Practice address
581 FOSTER CITY BLVD, FOSTER CITY, CA 94404-1695
(650) 286-9999
Mailing address
581 FOSTER CITY BLVD, FOSTER CITY, CA 94404-1695
(650) 286-9999
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
59748
CA
Other
Enumeration date
04/01/2013
Last updated
01/03/2022
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