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NPI Code Detail

MEDICARE: SANG PARK

MEDICARE: SANG 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
1363A00000XPhysician AssistantCA

General Provider Information

NPI Number : 1992657910
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANG PARK
Provider Business Mailing Address
First Line : 590 N VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-2115
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 590 N VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-2115
Country : US
Telephone Number : 323-284-7998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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Directions to “ SANG PARK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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