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1255768974
KENNETH PARK
SAN BERNARDINO, CA
NPI
1255768974
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA 68555)
Enumeration Date
2013-09-27
Last Update Date
2017-02-17
Business Address
Mr. KENNETH PARK
2372 STERLING AVE
SAN BERNARDINO, CA 92404-4624
Phone number: 310-421-9405
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Mailing Address
Mr. KENNETH PARK
2372 STERLING AVE
SAN BERNARDINO, CA 92404-4624
Phone number: 310-421-9405
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