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General NPI Number Information
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NPI Number | 1558487462
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Entity Type | Individual
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Provider Name | WILLIAM HOWARD PARK O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 47001 PALA RD
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City | TEMECULA
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State | CA
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Zip | 92592-2925
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Country | US
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Telephone | 951-676-6810
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Fax | 951-225-6873
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Provider Business Mailing Address
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Address Line | 47001 PALA RD
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City | TEMECULA
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State | CA
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Zip | 92592-2925
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Country | US
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Telephone | 951-676-6810
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Fax | 951-225-6873
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13082T
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License Number State | CA
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