Organization
KENNETH K. PARK, M.D., INC.
Active
Parent organization
KENNETH K. PARK, M.D., INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNETH K. PARK, M.D., INC.
Authorized official
KENNETH K PARK M.D. (MEDICAL DIRECTOR)
(310) 316-6190
Entity
Organization
Contact information
Practice address
23456 HAWTHORNE BLVD, SUITE 300, TORRANCE, CA 90505-4716
(310) 316-6190
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 100, LOS ANGELES, CA 90077-1726
(310) 943-4180
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A108380
CA
Other
Enumeration date
04/30/2014
Last updated
10/19/2015
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