Doctor Name: | DR. ALAN LESLIE PARK |
NPI Number: | 1225257074 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT |
License Number: | 1029783 |
Business Practice Address: | 13809 Southwest Fwy Sugar Land, TX - 774783533 |
Business Phone Number: | 2814940650 |
Business Fax Number: | 2812650616 |
Mailing Address: | 12572 Valley View St, GARDEN GROVE |
State: | CA |
Postal Code: | 928452006 |
Phone Number: | 7148234400 |
Fax Number: | 7148234404 |
NPI Enumeration Date: | 04/24/2007 |
NPI Last Update Date: | 09/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1029783 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |