MEDICARE: JULIE 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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH47521	CA

General Provider Information

NPI Number	:	1285036525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE PARK PHARM.D.

Provider Business Mailing Address
First Line	:	600 CITY PKWY W
Second Line	:	SUITE 800
City	:	ORANGE
State	:	CA
Zip	:	92868-2968
Country	:	US
Telephone Number	:	714-796-5925
Fax Number	:

Provider Business Practice Location Address
First Line	:	6189 LA PALMA AVE
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-2858
Country	:	US
Telephone Number	:	714-522-2891
Fax Number	:

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

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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Directions to “ JULIE PARK PHARM.D.” Practice Location

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