MEDICARE: DR. KITAE KEVIN PARK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	C56093	CA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	16037	HI
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	C56093	CA
4	207RP1001X	Pulmonary Disease Physician	16037	HI
5	207RP1001X	Pulmonary Disease Physician	C56093	CA

General Provider Information

NPI Number	:	1437335361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KITAE KEVIN PARK MD

Provider Business Mailing Address
First Line	:	PO BOX 845833
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90084-5833
Country	:	US
Telephone Number	:	310-792-3914
Fax Number	:	855-898-4055

Provider Business Practice Location Address
First Line	:	2251 W ROSECRANS AVE STE 21
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90222-3860
Country	:	US
Telephone Number	:	424-529-6755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2008
Last Update Date	:	03/17/2018

Similar Medicare Providers

1952305823 — JEAN MARIA MULLER MD, FACC
Practice Location Address:

2251 W ROSECRANS AVE STE 21
COMPTON, CA
90222-3860

Practice Phone: 424-529-6755
Practice Fax:

1295943884 — ANCIL K. PHILIP MD
Practice Location Address:

2251 W ROSECRANS AVE STE 21
COMPTON, CA
90222-3860

Practice Phone: 424-529-6755
Practice Fax:

1659324408 — DUAL DIAGNOSIS ASSESSMENT AND TREATMENT CENTER INC
Practice Location Address:

2600 N CENTRAL AVE , B1
COMPTON, CA
90222-1640

Practice Phone: 888-417-5163
Practice Fax: 888-316-1604

1356356042 — COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Practice Location Address:

1108 N OLEANDER AVE
COMPTON, CA
90222-4041

Practice Phone: 310-763-2244
Practice Fax:

1235247578 — COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Practice Location Address:

1108 N OLEANDER AVE
COMPTON, CA
90222-4041

Practice Phone: 310-763-2244
Practice Fax:

1881703247 — THRIFTY PAYLESS INC
Practice Location Address:

1001 NORTH CENTRAL AVENUE
COMPTON, CA
90222-3647

Practice Phone: 310-639-1278
Practice Fax:

Directions to “ DR. KITAE KEVIN PARK MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.