Healthcare Provider Details

I. General information

NPI: 1265395131
Provider Name (Legal Business Name): JOSHUA PARK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PASTEUR DR
PALO ALTO CA
94304-1048
US

IV. Provider business mailing address

500 PASTEUR DR
PALO ALTO CA
94304-1048
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License Number81735
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: