Park, Samuel
Park, Samuel is an sole proprietor health care provider with primary practice located at 9500 Gilman Drive Mc 0304, La Jolla CA 92093-0304. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Park, Samuel can be contacted via phone (858) 534-3755.Contact Information
Primary practice address
9500 Gilman Drive Mc 0304
La Jolla CA 92093-0304
Phone: (858) 534-3755
Fax: (858) 534-2628
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY16648 | California |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | PSY16648 | California |
Profile Details
| NPI number | 1578738522 |
|---|---|
| LBN Legal business name | Park, Samuel |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 29th, 2008 |
| Last updated | Apr 29th, 2008 - about 18 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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