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NPI Code Detail

MEDICARE: HOJUN PARK DDS

MEDICARE:   HOJUN  PARK  DDS
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
11223G0001XGeneral Practice Dentistry105381CA

General Provider Information

NPI Number : 1093371056
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOJUN PARK DDS
Provider Business Mailing Address
First Line : 95 BELLEVUE AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95110-3604
Country : US
Telephone Number : 408-674-5674
Fax Number :
Provider Business Practice Location Address
First Line : 3030 EXPLORER DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95827-2728
Country : US
Telephone Number : 916-642-1867
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2019
Last Update Date : 10/28/2021

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Directions to “ HOJUN PARK DDS” Practice Location

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