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NPI Code Detail

MEDICARE: ESTHER YEARAM PARK

MEDICARE: ESTHER YEARAM PARK
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1508279076
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESTHER YEARAM PARK
Provider Business Mailing Address
First Line : 1355 S HILL ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3012
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1355 S HILL ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3012
Country : US
Telephone Number : 213-389-5820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2014
Last Update Date : 07/28/2015

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Directions to “ ESTHER YEARAM PARK ” Practice Location

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