Joong Y Park
General Practice Physician
3511 W Olympic Bl #101
Los Angeles
, California 90019
Joong Y Park
General Practice Physician
3511 W Olympic Bl #101
Los Angeles
, California 90019
(323) 766-8790
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Joong Y Park
- 3511 W Olympic Bl #101
- Los Angeles, CA
- Zip : 90019
- Fax : (323) 766-8790
- Phone : (323) 766-1057
Second Address
- Joong Y Park
- 3511 W Olympic Bl #101
- Los Angeles, CA
- Zip : 90019
- Fax : (323) 766-8790
- Phone : (323) 766-1057
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | A39059 | CA |
National Provider Identifier
| NPI | 1003839002 |
|---|---|
| Provider Name | Joong Y Park |
| First Address | Los Angeles, CA 90019 |
| Second Address | Los Angeles, CA 90019 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/07/2006 |
| Last Update Date | 06/12/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00A390590 | (05) | CA |
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.