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NPI Code Detail

MEDICARE: DR. SANG WOO PARK O.M.D.

MEDICARE:  DR. SANG WOO PARK  O.M.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
1171100000XAcupuncturistAC 3911CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144368747
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANG WOO PARK O.M.D.
Provider Business Mailing Address
First Line : 945 S WESTERN AVE
Second Line : # 203
City : LOS ANGELES
State : CA
Zip : 90006-1008
Country : US
Telephone Number : 323-730-0700
Fax Number : 323-730-0373
Provider Business Practice Location Address
First Line : 945 S WESTERN AVE
Second Line : # 203
City : LOS ANGELES
State : CA
Zip : 90006-1008
Country : US
Telephone Number : 323-730-0700
Fax Number : 323-730-0373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2007
Last Update Date : 07/08/2007

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Directions to “ DR. SANG WOO PARK O.M.D.” Practice Location

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