Organization
RICHARD PARK M.D., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD PARK M.D. (CEO/PHYSICIAN)
(818) 678-9875
Entity
Organization
Contact information
Practice address
10515 BALBOA BLVD STE 325, GRANADA HILLS, CA 91344-6364
(818) 678-9875
(747) 200-2589
Mailing address
2709 ROCKY POINT CT, THOUSAND OAKS, CA 91362-4943
(805) 368-1293
(888) 981-8739
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QM2800X
Methadone Clinic
—
—
Other
Enumeration date
03/25/2013
Last updated
04/09/2024
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