KELLY PARK

ANTIOCH, CA
NPI1346536349
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: CA  20007)
Additional Taxonomies207V00000X Obstetrics & Gynecology
(Licence: NJ  25MB10893000)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2011-06-28
Last Update Date2023-01-25
Business Address
KELLY PARK D.O.
4501 SAND CREEK RD
ANTIOCH, CA 94531-8687
Phone number: 925-813-6500
Mailing Address
KELLY PARK D.O.
4501 SAND CREEK RD
ANTIOCH, CA 94531-8687
Phone number: