Park, Jung Mok

Park, Jung Mok is an individual health care provider with primary practice located at 11480 Brookshire Ave Suite 204, Downey CA 90241-5026. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Park, Jung Mok can be contacted via phone (562) 862-2775.

Contact Information

Primary practice address
11480 Brookshire Ave Suite 204 Downey CA 90241-5026
Phone: (562) 862-2775
Fax: (562) 904-8095
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X A52223 California
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 52223 California

Profile Details

NPI number 1508872243
LBN Legal business name Park, Jung Mok
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Sep 21st, 2016 - about 10 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 1508872243 NPPES
California Other 00A522230 BLUE SHIELD
California Other 160055247 BLUE SHIELD
California MEDICAID 00A522230 BLUE SHIELD
California Other 160055247 BLUE SHIELD

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