Park, Jung K
Park, Jung K is an individual health care provider with primary practice located at 11209 N Tatum Blvd Suite #110, Phoenix AZ 85028-3091. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Park, Jung K can be contacted via phone (602) 248-8002.Contact Information
Primary practice address
11209 N Tatum Blvd Suite #110
Phoenix AZ 85028-3091
Phone: (602) 248-8002
Fax: (602) 248-8399
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 26466 | Arizona |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | F91378 | Arizona |
Profile Details
| NPI number | 1700834777 |
|---|---|
| LBN Legal business name | Park, Jung K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Sep 11th, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700834777 | NPPES |
| Arizona | Other | 1Z7049 | HEALTHNET |
| Arizona | Other | AZ0324990 | HEALTHNET |
| Arizona | Other | 431726 | HEALTHNET |
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