Joong Young Park M.d. Inc. | |
9535 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1551 | |
(714) 534-1112 | |
(714) 534-1116 |
Full Name | Joong Young Park M.d. Inc. |
---|---|
Speciality | General Practice |
Location | 9535 Garden Grove Blvd Ste 104, Garden Grove, California |
Authorized Official Name and Position | Joong Young Park (PRESIDENT) |
Authorized Official Contact | 7145341112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Joong Young Park M.d. Inc. 9535 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1551 Ph: (714) 534-1112 | Joong Young Park M.d. Inc. 9535 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1551 Ph: (714) 534-1112 |
NPI Number | 1104014034 |
---|---|
Provider Enumeration Date | 10/04/2007 |
Last Update Date | 09/16/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104014034 | NPI | - | NPPES |
00A390590 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | A39059 (California) | Primary |
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