Jeong Sik Park MD a Prof Corp
NPI #1558524306 in Clearlake, California
Provider Information
- NPI Number
- 1558524306
- Entity Type
- Organization
- Organization Name
- Jeong Sik Park MD a Prof Corp
- Primary Specialty
- Specialist
- Enumeration Date
- Jul 2, 2008
- Last Updated
- Jul 2, 2008
Practice Location
- Address
- 15250 LAKESHORE DR STE C
- City
- Clearlake
- State
- California
- ZIP Code
- 95422-8107
- Phone
- (707) 995-7077
Authorized Official
- Name
- COLLEEN BRADRICK
- Title
- MEDICAL BILLER
- Phone
- (707) 994-8818
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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