Park, James Jongtak

Park, James Jongtak is an individual health care provider with primary practice located at 17822 Beach Blvd Suite 419, Huntington Beach CA 92647-7101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Park, James Jongtak can be contacted via phone (714) 841-9922.

Contact Information

Primary practice address
17822 Beach Blvd Suite 419 Huntington Beach CA 92647-7101
Phone: (714) 841-9922
Fax: (714) 841-3292
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 20A7365 California

Profile Details

NPI number 1306871421
LBN Legal business name Park, James Jongtak
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jul 26th, 2007 - about 17 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 1306871421 NPPES
California Other 00AX73650 MEDI-CAL
California Other ZZZ04904Z MEDI-CAL

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