Healthcare Provider Details

I. General information

NPI: 1992738843
Provider Name (Legal Business Name): ARTHUR MYUNGHOON PARK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9508 STOCKDALE HWY SUITE 110
BAKERSFIELD CA
93311-3622
US

IV. Provider business mailing address

2502 TIVERTON DR
BAKERSFIELD CA
93311-9387
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-0818
  • Fax: 661-663-0516
Mailing address:
  • Phone: 661-663-0818
  • Fax: 661-663-0516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA44597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: