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NPI Code Detail

MEDICARE: GYOUNG J PARK M.D.

MEDICARE:   GYOUNG 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
1174400000XSpecialist

General Provider Information

NPI Number : 1871532309
Entity Type Code : Individual
Provider Name (Legal Business Name) : GYOUNG J PARK M.D.
Provider Business Mailing Address
First Line : 4620 BEVERLY BLVD FL 2
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-3102
Country : US
Telephone Number : 323-460-2121
Fax Number : 213-748-7003
Provider Business Practice Location Address
First Line : 4620 BEVERLY BLVD 2ND FL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-3102
Country : US
Telephone Number : 323-460-2121
Fax Number : 213-748-7003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 02/10/2026

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

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