Sophia Anne Park, MD
Pediatrics in Los Angeles, CA. Individual provider (NPI-1).
NPI number1801425715
StatusActive
Last updated in NPPESOct 27, 2023
Details
- NPI
- 1801425715
- Entity type
- Individual (NPI-1)
- Name
- Sophia Anne Park
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 2, 2020
- Certification date
- Aug 10, 2023
- Last updated
- Oct 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | A186190 | CA | Yes |
Other names
- Seonyeong Park (Former Name)
Practice location
4650 W Sunset BlvdLos Angeles, CA 90027-6062
Phone 888-499-9303
Mailing address
4650 W Sunset Blvd # Ms 76Los Angeles, CA 90027-6062
Phone 888-499-9303
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