Christina Park, FNP-C | |
5630 E Santa Ana Canyon Rd Ste 100, Anaheim, CA 92807-3122 | |
(714) 257-6170 | |
Not Available |
Full Name | Christina Park |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 5630 E Santa Ana Canyon Rd Ste 100, Anaheim, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295592293 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 95029338 (California) | Primary |
Entity Name | Providence Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
Mailing Address | Practice Location Address |
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Christina Park, FNP-C 1142 S Diamond Bar Blvd # 383, Diamond Bar, CA 91765-2203 Ph: () - | Christina Park, FNP-C 5630 E Santa Ana Canyon Rd Ste 100, Anaheim, CA 92807-3122 Ph: (714) 257-6170 |
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