| Jin Park Dds, Inc | |
|
2727 W Olympic Blvd 301 Los Angeles CA 90006-2637 | |
| (213) 385-8000 | |
| Not Available |
| Full Name | Jin Park Dds, Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2727 W Olympic Blvd, Los Angeles, California |
| Authorized Official Name and Position | Jin Park (CEO) |
| Authorized Official Contact | 2133858000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jin Park Dds, Inc 2727 W Olympic Blvd 301 Los Angeles CA 90006-2637 Ph: (213) 385-8000 | Jin Park Dds, Inc 2727 W Olympic Blvd 301 Los Angeles CA 90006-2637 Ph: (213) 385-8000 |
| NPI Number | 1255453668 |
|---|---|
| Provider Enumeration Date | 04/05/2007 |
| Last Update Date | 05/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255453668 | NPI | - | NPPES |
| D47406 | Medicaid | CA | |
| 47406 | Other | CA | CA CHILDREN'S SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 47406 (California) | Primary |
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