Park, Samuel Mo

Park, Samuel Mo is an individual health care provider with primary practice located at 340 W East Ave , Chico CA 95926-7238. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Park, Samuel Mo can be contacted via phone (530) 342-2777.

Contact Information

Primary practice address
340 W East Ave Chico CA 95926-7238
Phone: (530) 342-2777
Fax: (530) 342-2776
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 35076716P Ohio
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X G87601 California

Profile Details

NPI number 1740285907
LBN Legal business name Park, Samuel Mo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Dec 15th, 2021 - about 4 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 1740285907 NPPES
California MEDICAID 3697637

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