| Doctor Name: | DR. JINHA MARK PARK |
| NPI Number: | 1811036619 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., PH.D. |
| License Number: | A80100 |
| Business Practice Address: | 1500 East Duarte Road Room 1300 Duarte, CA - 910103000 |
| Business Phone Number: | 6262568767 |
| Business Fax Number: | 6269305451 |
| Mailing Address: | 1333 S Mayflower Ave 2nd Fl, MONROVIA |
| State: | CA |
| Postal Code: | 910164066 |
| Phone Number: | 6267753514 |
| Fax Number: | 6264083911 |
| NPI Enumeration Date: | 02/06/2007 |
| NPI Last Update Date: | 08/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | A80100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |