Individual
ELLEN SAE EUN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
6900 LINCOLN AVE, BUENA PARK, CA 90620-4148
(714) 522-4009
Mailing address
6900 LINCOLN AVE, BUENA PARK, CA 90620-4148
(714) 522-4009
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95005023
CA
Other
Enumeration date
10/19/2016
Last updated
04/23/2021
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