| Joong Young Park M.d. Inc. | |
|
9535 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1551 | |
| (714) 534-1112 | |
| (714) 534-1116 |
| Full Name | Joong Young Park M.d. Inc. |
|---|---|
| Speciality | General Practice |
| Location | 9535 Garden Grove Blvd Ste 104, Garden Grove, California |
| Authorized Official Name and Position | Joong Young Park (PRESIDENT) |
| Authorized Official Contact | 7145341112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joong Young Park M.d. Inc. 9535 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1551 Ph: (714) 534-1112 | Joong Young Park M.d. Inc. 9535 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1551 Ph: (714) 534-1112 |
| NPI Number | 1104014034 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 09/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104014034 | NPI | - | NPPES |
| 00A390590 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A39059 (California) | Primary |
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