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General NPI Number Information
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NPI Number | 1710293675
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Entity Type | Individual
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Provider Name | NAOMI PARK MD
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Gender | Female
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Dates
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Enumeration Date | 08/29/2010
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 2355 E CAMELBACK RD STE 625
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City | PHOENIX
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State | AZ
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Zip | 85016-3458
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Country | US
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Telephone | 480-626-7584
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Fax | 480-210-0230
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Provider Business Mailing Address
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Address Line | 3300 N TRIUMPH BLVD STE 500
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City | LEHI
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State | UT
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Zip | 84043-6475
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Country | US
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Telephone | 801-821-2781
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C170746
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 48687
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License Number State | AZ
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