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NPI Code Detail

MEDICARE: BYUNG HEE PARK L.A.C

MEDICARE:   BYUNG HEE PARK  L.A.C
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
1171100000XAcupuncturist5106CA

General Provider Information

NPI Number : 1639315393
Entity Type Code : Individual
Provider Name (Legal Business Name) : BYUNG HEE PARK L.A.C
Provider Business Mailing Address
First Line : 3750 W 6TH ST STE 203
Second Line :
City : LOS ANGELES
State : CA
Zip : 90020-5107
Country : US
Telephone Number : 213-505-3388
Fax Number :
Provider Business Practice Location Address
First Line : 3750 W 6TH ST STE 203
Second Line :
City : LOS ANGELES
State : CA
Zip : 90020-5107
Country : US
Telephone Number : 213-505-3388
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2008
Last Update Date : 12/31/2008

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Directions to “ BYUNG HEE PARK L.A.C” Practice Location

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