Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A100010 | CA |
Y | 208600000X | Surgeon | A100010 | CA |
NPI | 1013232917 |
---|---|
Provider Name | Dr. Cheryl Lin Park |
First Address | Richmond, CA 94804-4555 |
Second Address | Oakland, CA 94602-1018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2010 |
Last Update Date | 13/12/2021 |