MEDICARE: DAVID J PARK 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
1	207RX0202X	Medical Oncology Physician	A75876	CA

General Provider Information

NPI Number	:	1275619447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J PARK M.D.

Provider Business Mailing Address
First Line	:	2151 N HARBOR BLVD STE 3200
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92835-3826
Country	:	US
Telephone Number	:	714-446-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2151 N HARBOR BLVD
Second Line	:	SUITE 2200
City	:	FULLERTON
State	:	CA
Zip	:	92835-3801
Country	:	US
Telephone Number	:	714-446-5900
Fax Number	:	714-446-5800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	12/03/2021

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Directions to “ DAVID J PARK M.D.” Practice Location

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