Susan Jung Park Valid NPI
Individual provider · Family Medicine Physician · Fountain Valley, CA
- NPI
- 1114253515
- Type
- Individual (Type 1)
- Primary specialty
- Family Medicine Physician (Family Medicine)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 207Q00000X
- License number
- 77563 (CA)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2009-10-20
- Last updated
- 2010-05-19
Practice location
11420 Warner Ave
Fountain Valley, CA 92708-2529
(714) 549-1300