MEDICARE: HYUNWOOK 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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1851149884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYUNWOOK PARK

Provider Business Mailing Address
First Line	:	1221 W 3RD ST APT 626
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-5196
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8647 FENWICK ST
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-1957
Country	:	US
Telephone Number	:	818-352-1421
Fax Number	:

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

Provider Enumeration Date	:	05/06/2024
Last Update Date	:	05/06/2024

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Directions to “ HYUNWOOK PARK ” Practice Location

Language	Start Address	Practice Location

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