Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 125059823 | IL |
Y | 207VX0201X | Gynecologic Oncologist | A160736 | CA |
NPI | 1184910960 |
---|---|
Provider Name | Dr. Hyo Kyung Park |
First Address | Los Angeles, CA 90027-6098 |
Second Address | Los Angeles, CA 90027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2011 |
Last Update Date | 17/02/2020 |