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General NPI Number Information
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NPI Number | 1134051451
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Entity Type | Individual
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Provider Name | NOAH YOUNGCHAN PARK CAA
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Gender | Male
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 12605 E 16TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2520
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Country | US
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Telephone | 720-848-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 BANNER RIDGE RD
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2301
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | ANT.0000340
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License Number State | CO
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