Park, Edward Y

Park, Edward Y is an individual health care provider with primary practice located at 2149 E Warner Rd Ste 102 , Tempe AZ 85284-3495. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Park, Edward Y can be contacted via phone (480) 610-6100.

Contact Information

Primary practice address
2149 E Warner Rd Ste 102 Tempe AZ 85284-3495
Phone: (480) 610-6100
Fax: (480) 464-0189
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 4218 Arizona

Profile Details

NPI number 1497783971
LBN Legal business name Park, Edward Y
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Jan 19th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497783971 NPPES
Arizona Other 4218 ARIZONA STATE LICENSE
Arizona MEDICAID 2675627 ARIZONA STATE LICENSE
Arizona Other 000000483998 ARIZONA STATE LICENSE
Arizona MEDICAID 182405 ARIZONA STATE LICENSE

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