Park, Sungkook Andrew
Park, Sungkook Andrew is an individual health care provider with primary practice located at 8402 Centennial Pkwy , Las Vegas NV 89149. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Park, Sungkook Andrew can be contacted via phone (702) 948-8660.Contact Information
Primary practice address
8402 Centennial Pkwy
Las Vegas NV 89149
Phone: (702) 948-8660
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 17024 | Nevada |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 17024 | Nevada |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 17024 | Nevada |
Profile Details
| NPI number | 1972869345 |
|---|---|
| LBN Legal business name | Park, Sungkook Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2012 |
| Last updated | Jul 21st, 2022 - about 3 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 | 1972869345 | NPPES |
| Nevada | MEDICAID | 1972869345 |
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