| Doctor Name: | JOONG Y PARK |
| NPI Number: | 1003839002 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A39059 |
| Business Practice Address: | 3511 W Olympic Bl #101 Los Angeles, CA - 90019 |
| Business Phone Number: | 3237661057 |
| Business Fax Number: | 3237668790 |
| Mailing Address: | 3511 W Olympic Bl, #101 LOS ANGELES |
| State: | CA |
| Postal Code: | 90019 |
| Phone Number: | 3237661057 |
| Fax Number: | 3237668790 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 12/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A39059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |