Jinsu Park
Student in an Organized Health Care Education/Training Program in Marina, CA. Individual provider (NPI-1).
NPI number1982159091
StatusActive
Last updated in NPPESAug 18, 2016
Details
- NPI
- 1982159091
- Entity type
- Individual (NPI-1)
- Name
- Jinsu Park
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 18, 2016
- Last updated
- Aug 18, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
3030 Antietam CtMarina, CA 93933-4901
Phone 831-917-8379
Mailing address
3030 Antietam CtMarina, CA 93933-4901
Phone 831-917-8379
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