Park, John W

Park, John W is an individual health care provider with primary practice located at 1600 Divisadero St 2Nd Floor, Box 1710, San Francisco CA 94115-3010. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Park, John W can be contacted via phone (415) 353-7070.

Contact Information

Primary practice address
1600 Divisadero St 2Nd Floor, Box 1710 San Francisco CA 94115-3010
Phone: (415) 353-7070
Fax: (415) 353-7021
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X G63196 California

Profile Details

NPI number 1053375444
LBN Legal business name Park, John W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Jul 9th, 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 1053375444 NPPES
California MEDICAID 00G631960

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