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8428 Alondra Blvd Paramount CA 90723-4406 | |
| (562) 633-6566 | |
| (562) 633-3308 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8428 Alondra Blvd, Paramount, California |
| Authorized Official Name and Position | Jin S Park (CEO) |
| Authorized Official Contact | 5626336566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8428 Alondra Blvd Paramount CA 90723-4406 Ph: (562) 633-6566 | 8428 Alondra Blvd Paramount CA 90723-4406 Ph: (562) 633-6566 |
| NPI Number | 1982733770 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982733770 | NPI | - | NPPES |
| B 37476 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 37476 (California) | Primary |
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