Michael Park

NPI #1013514777 in Los Angeles, California

Provider Information

NPI Number: 1013514777
Entity Type: Individual
Name: Michael Park
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Oct 6, 2020
Last Updated: Jun 6, 2023

Practice Location

Address: 515 COLUMBIA AVE STE 200
City: Los Angeles
State: California
ZIP Code: 90017-1209
Phone: (213) 219-5802

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X
Specialist	174400000X	Primary

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