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NPI Code Detail

MEDICARE: EUNICE PARK PHARM.D

MEDICARE: EUNICE PARK PHARM.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH61219CA
2183500000XPharmacist61219CA

General Provider Information

NPI Number : 1023339181
Entity Type Code : Individual
Provider Name (Legal Business Name) : EUNICE PARK PHARM.D
Provider Business Mailing Address
First Line : 1701 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90006-5803
Country : US
Telephone Number : 323-731-9247
Fax Number :
Provider Business Practice Location Address
First Line : 1701 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90006-5803
Country : US
Telephone Number : 323-731-9247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2010
Last Update Date : 02/08/2022

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Directions to “ EUNICE PARK PHARM.D” Practice Location

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