| Doctor Name: | MRS. NURI PARK |
| NPI Number: | 1003955667 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | NP16060 |
| Business Practice Address: | 23181 Verdugo Dr Ste 103a Laguna Hills, CA - 926531313 |
| Business Phone Number: | 9493661053 |
| Business Fax Number: | 9493667710 |
| Mailing Address: | 17711 Kennon Dr, YORBA LINDA |
| State: | CA |
| Postal Code: | 928863963 |
| Phone Number: | 6266449083 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2007 |
| NPI Last Update Date: | 11/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | NP16060 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |