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12122 Garfield Ave South Gate CA 90280-8033 | |
(714) 501-3433 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 12122 Garfield Ave, South Gate, California |
Authorized Official Name and Position | Timothy Changkeun Park (HEAD DOCTOR) |
Authorized Official Contact | 7145013433 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12124 Garfield Ave South Gate CA 90280-8033 Ph: (323) 775-9070 | 12122 Garfield Ave South Gate CA 90280-8033 Ph: (714) 501-3433 |
NPI Number | 1255935771 |
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Provider Enumeration Date | 11/25/2020 |
Last Update Date | 01/14/2021 |
Identifier | Type | State | Issuer |
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1255935771 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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