Individual
DR. JOON PARK
Active
Individual
DR. JOON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
E9904
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44268
PRESBYTERIAN COMMERCIAL
NM
05
—
44268
—
NM
01
—
80896Z
HMO BLUE
TX
01
—
85E551
BC/BS
TX
01
—
A078
TRIWEST
NM
05
—
V3884
—
NM
Enumeration date
11/09/2005
Last updated
07/13/2007
Update your record
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