Doctor Name: | DR. ANDREW PARK |
NPI Number: | 1184840217 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC, CCSP |
License Number: | DC30265 |
Business Practice Address: | 4482 Barranca Pkwy Suite 192 Irvine, CA - 926047701 |
Business Phone Number: | 9495525094 |
Business Fax Number: | 9495525096 |
Mailing Address: | 1163 W 9th St, 1 SAN PEDRO |
State: | CA |
Postal Code: | 907313436 |
Phone Number: | 7143882461 |
Fax Number: | |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 04/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC30265 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |