Park, Sangdo
Park, Sangdo is an sole proprietor health care provider with primary practice located at 2105 Beverly Blvd Suite 223, Los Angeles CA 90057-2216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Park, Sangdo can be contacted via phone (213) 989-0644.Contact Information
Primary practice address
2105 Beverly Blvd Suite 223
Los Angeles CA 90057-2216
Phone: (213) 989-0644
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | N6562 | Texas |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | A107642 | California |
Profile Details
| NPI number | 1164582656 |
|---|---|
| LBN Legal business name | Park, Sangdo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Oct 24th, 2012 - about 13 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 | 1164582656 | NPPES |
| Texas | Other | 8W9051 | BCBS |
| Texas | Other | 8CR159 | BCBS |
| Texas | Other | P00935331 | BCBS |
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