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NPI Code Detail

MEDICARE: DR. LOUIS SANG-SOO PARK M.D.

MEDICARE: DR. LOUIS SANG-SOO 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
1207RP1001XPulmonary Disease PhysicianG79245CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00156667OTHERCARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962446039
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUIS SANG-SOO PARK M.D.
Provider Business Mailing Address
First Line : 1300 N VERMONT AVE
Second Line : # 600
City : LOS ANGELES
State : CA
Zip : 90027-6098
Country : US
Telephone Number : 213-484-8446
Fax Number : 323-913-4351
Provider Business Practice Location Address
First Line : 1300 N VERMONT AVE
Second Line : # 600
City : LOS ANGELES
State : CA
Zip : 90027-6098
Country : US
Telephone Number : 213-484-8446
Fax Number : 323-913-4351
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 10/12/2017

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