Organization
LIVINGSTONE COMMUNITY DEVELOPMENT CORPORATION
Active
Other names
Livingstone Community Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYUNG I. PARK MD (CEO)
(714) 248-9500
Entity
Organization
Contact information
Practice address
111 W BASTANCHURY RD, UNIT 1A, FULLERTON, CA 92835-2527
(714) 248-9500
(714) 622-4943
Mailing address
111 W BASTANCHURY RD, UNIT 1A, FULLERTON, CA 92835-2527
(714) 248-9500
(714) 622-4943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/20/2020
Last updated
06/20/2020
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