Individual
ELLEN JIWON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 SAN PABLO ST, 4TH FLOOR ANES, LOS ANGELES, CA 90033-5313
(323) 442-7400
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-7400
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A110668
CA
207LP3000X
Pediatric Anesthesiology Physician
A110668
CA
207R00000X
Internal Medicine Physician
236820
MA
Other
Enumeration date
06/23/2008
Last updated
11/07/2017
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