Organization
SAMUEL W PARK MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN A REIMER (CREDENTIALING)
(949) 294-0692
Entity
Organization
Contact information
Practice address
26730 CROWN VALLEY PKWY, SUITE 200, MISSION VIEJO, CA 92691-6364
(949) 364-2154
(949) 496-8872
Mailing address
26730 CROWN VALLEY PKWY, SUITE 200, MISSION VIEJO, CA 92691-6364
(949) 364-2154
(949) 496-8872
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A96320
CA
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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