Park, Jung K

Park, Jung K is an individual health care provider with primary practice located at 11209 N Tatum Blvd Suite #110, Phoenix AZ 85028-3091. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Park, Jung K can be contacted via phone (602) 248-8002.

Contact Information

Primary practice address
11209 N Tatum Blvd Suite #110 Phoenix AZ 85028-3091
Phone: (602) 248-8002
Fax: (602) 248-8399
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X F91378 Arizona

Profile Details

NPI number 1700834777
LBN Legal business name Park, Jung K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jul 8th, 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 1700834777 NPPES
Arizona Other 1Z7049 HEALTHNET
Arizona Other AZ0324990 HEALTHNET
Arizona Other 431726 HEALTHNET

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