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1932289030
MICHAEL KWANSUP PARK
OAKLAND, CA
NPI
1932289030
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: CA G75378)
Enumeration Date
2006-10-16
Last Update Date
2019-08-27
Business Address
Dr. MICHAEL KWANSUP PARK MD
1940 WEBSTER ST 2ND FLOOR
OAKLAND, CA 94612-2920
Phone number: 510-463-4700
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Mailing Address
Dr. MICHAEL KWANSUP PARK MD
5700 TELEGRAPH AVE STE 100
OAKLAND, CA 94609-1710
Phone number: 510-463-4700
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