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Individual

MRS. ELLEN JUNG PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14119 DEERBROOK LN, CHINO HILLS, CA 91709-4807
(909) 628-9904
Mailing address
14119 DEERBROOK LN, CHINO HILLS, CA 91709-4807
(909) 628-9904

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2736
CA

Other

Enumeration date
12/22/2009
Last updated
12/22/2009
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