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General NPI Number Information
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NPI Number | 1801227913
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Entity Type | Organization
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Legal Business Name | ALANE PARK MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/29/2013
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Last Update Date | 11/29/2013
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BLVD SUITE 605
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City | LOS ANGELES
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State | CA
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Zip | 90017-4810
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Country | US
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Telephone | 213-294-2160
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Fax | 213-294-2165
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Provider Business Mailing Address
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Address Line | 12930 VENTURA BLVD #643
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City | STUDIO CITY
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State | CA
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Zip | 91604-2200
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Country | US
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Telephone | 213-294-2160
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Fax | 213-294-2165
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALANE PARK
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Credential | M.D.
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Telephone | 213-294-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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