| Organization Name: | JOONG YOUNG PARK M.D. INC. |
| NPI Number: | 1104014034 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOONG YOUNG PARK (PRESIDENT) |
| Mailing Address: | 9535 Garden Grove Blvd Ste 104 Garden Grove |
| State: | CA US |
| Postal Code: | 928441551 |
| Phone Number: | 7145341112 |
| Fax Number: | 7145341116 |
| NPI Enumeration Date: | 10/04/2007 |
| NPI Last Update Date: | 09/16/2009 |
| 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: | |