| Doctor Name: | TAIKEUN PARK |
| NPI Number: | 1831175918 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | C51444 |
| Business Practice Address: | 251 Landis Avenue Chula Vista, CA - 919109578 |
| Business Phone Number: | 6195152500 |
| Business Fax Number: | 6199349578 |
| Mailing Address: | 823 Gateway Center Way, SAN DIEGO |
| State: | CA |
| Postal Code: | 921024541 |
| Phone Number: | 6195152323 |
| Fax Number: | 6199064564 |
| NPI Enumeration Date: | 12/20/2005 |
| NPI Last Update Date: | 10/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C51444 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |