Doctor Name: | SUSAN YOOSHIN PARK |
NPI Number: | 1467668772 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | A94505 |
Business Practice Address: | 25 Altino Newport Coast, CA - 926571303 |
Business Phone Number: | 9525951100 |
Business Fax Number: | 6122944903 |
Mailing Address: | 11995 Singletree Ln, Suite 500 EDEN PRAIRIE |
State: | MN |
Postal Code: | 553445347 |
Phone Number: | 9525951301 |
Fax Number: | 6122944903 |
NPI Enumeration Date: | 05/15/2007 |
NPI Last Update Date: | 06/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | A94505 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |