| Organization Name: | CHRIS J PARK DPM, INC |
| NPI Number: | 1235312935 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRIS J PARK (OWNER) |
| Mailing Address: | 18895 Colima Rd Suite A Rowland Heights |
| State: | CA US |
| Postal Code: | 917482978 |
| Phone Number: | 6269130948 |
| Fax Number: | 6268541422 |
| NPI Enumeration Date: | 12/17/2007 |
| NPI Last Update Date: | 04/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP1100X |
| License Number: | E4168 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Podiatric |
| Taxonomy Definition: | |