Organization
SONNY PARK PC
Active
Other names
Columbia Pacific Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANGKUN (SONNY) PARK MD (OWNER)
(503) 325-5360
Entity
Organization
Contact information
Practice address
2120 EXCHANGE ST, STE 200, ASTORIA, OR 97103-3365
(503) 325-5360
(503) 325-9373
Mailing address
2120 EXCHANGE ST, STE 200, ASTORIA, OR 97103-3365
(503) 325-5360
(503) 325-9373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18585
OR
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091424000
REGENCE GROUP NUMBER
OR
05
—
286976
—
OR
Enumeration date
04/06/2007
Last updated
10/03/2012
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