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General NPI Number Information
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NPI Number | 1588727473
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Entity Type | Organization
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Legal Business Name | SUNMIN PARK MD A CALIFORNIA MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 2727 WEST OLYMPIC BLVD SUITE 313
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City | LOS ANGELES
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State | CA
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Zip | 90006-2699
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Country | US
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Telephone | 213-736-0010
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Fax | 213-736-0020
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Provider Business Mailing Address
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Address Line | 2727 W. OLYMPIC BLVD SUITE 313
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City | LOS ANGELES
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State | CA
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Zip | 90006-2699
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Country | US
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Telephone | 213-736-0010
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Fax | 213-736-0020
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Authorized Official
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Title or Position | CEO/OWNER/PROVIDER
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Name | SUNMIN PARK
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Credential | MD
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Telephone | 213-736-0010
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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 | G74656
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License Number State | CA
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