Park, Susan Jin-Sun

Park, Susan Jin-Sun is an individual health care provider with primary practice located at 661 Sierra Rose Dr , Reno NV 89511. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Park, Susan Jin-Sun can be contacted via phone (775) 982-8255.

Contact Information

Primary practice address
661 Sierra Rose Dr Reno NV 89511
Phone: (775) 982-8255
Fax: (775) 982-8251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 13322 Nevada
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X A98140 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 13322 Nevada

Profile Details

NPI number 1003070640
LBN Legal business name Park, Susan Jin-Sun
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2008
Last updated Jun 21st, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003070640 NPPES
Other 12139950 CAQH

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