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:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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