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General NPI Number Information
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NPI Number | 1144407230
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Entity Type | Individual
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Provider Name | SUNG AH PARK LAC, PHD, QME
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Gender | Female
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 670 E COMMONWEALTH AVE # A
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City | FULLERTON
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State | CA
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Zip | 92831-4514
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Country | US
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Telephone | 714-870-7575
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Fax | 714-870-7576
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Provider Business Mailing Address
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Address Line | 670 E COMMONWEALTH AVE # A
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City | FULLERTON
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State | CA
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Zip | 92831-4514
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Country | US
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Telephone | 714-870-7575
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Fax | 714-870-7576
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC6749
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License Number State | CA
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