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General NPI Number Information
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NPI Number | 1861575680
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Entity Type | Organization
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Legal Business Name | HANA OB/GYN MEDICAL GROUP INC.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2017 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90006-3705
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Country | US
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Telephone | 213-381-6001
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Fax | 213-381-6013
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Provider Business Mailing Address
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Address Line | 2017 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90006-3705
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Country | US
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Telephone | 213-381-6001
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Fax | 213-381-6013
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. KERRY PARK
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Credential | MD
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Telephone | 213-381-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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