Dr. Sue Jean Park
Dentist Anesthesiologist
11693 San Vicente Blvd # 207
Los Angeles
, California 90049-5105
Dr. Sue Jean Park
Dentist Anesthesiologist
11693 San Vicente Blvd # 207
Los Angeles
, California 90049-5105
(310) 477-7787
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About
Features
Specialties
- Dentist Anesthesiologist
Languages spoken
- English
Location
First Address
- Dr. Sue Jean Park
- 11693 San Vicente Blvd # 207
- Los Angeles, CA
- Zip : 90049-5105
- Fax : (310) 477-7787
- Phone : (562) 201-2221
Second Address
- Dr. Sue Jean Park
- 11693 San Vicente Blvd # 207
- Los Angeles, CA
- Zip : 90049-5105
- Fax : (310) 477-7787
- Phone : (562) 201-2221
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223D0004X | Dentist Anesthesiologist | 58385 | CA |
National Provider Identifier
| NPI | 1659600682 |
|---|---|
| Provider Name | Dr. Sue Jean Park |
| First Address | Los Angeles, CA 90049-5105 |
| Second Address | Los Angeles, CA 90049-5105 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/12/2009 |
| Last Update Date | 22/05/2013 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.