| Woori Medical Group Professional Corp | |
|
7825 Engineer Rd Ste 101 San Diego CA 92111-1924 | |
| (858) 277-7111 | |
| (858) 277-7667 |
| Full Name | Woori Medical Group Professional Corp |
|---|---|
| Speciality | General Practice |
| Location | 7825 Engineer Rd, San Diego, California |
| Authorized Official Name and Position | Ro Jong Park (PRESIDENT) |
| Authorized Official Contact | 8582777111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woori Medical Group Professional Corp 7825 Engineer Rd Ste 101 San Diego CA 92111-1924 Ph: (858) 277-7111 | Woori Medical Group Professional Corp 7825 Engineer Rd Ste 101 San Diego CA 92111-1924 Ph: (858) 277-7111 |
| NPI Number | 1275764706 |
|---|---|
| Provider Enumeration Date | 07/31/2009 |
| Last Update Date | 03/20/2015 |
| Medicare PECOS PAC ID | 5799831848 |
|---|---|
| Medicare Enrollment ID | O20090915000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275764706 | NPI | - | NPPES |
| 1275764706 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | C51444 (California) | Secondary |
| 208D00000X | General Practice | C51913 (California) | Primary |
| Provider Name | Ro J Park |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1699799593 PECOS PAC ID: 9638120280 Enrollment ID: I20070627000748 |
| Provider Name | Choon S Rim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083827273 PECOS PAC ID: 3072576784 Enrollment ID: I20131108000891 |
| Provider Name | Jessica Seungeun Baik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386168821 PECOS PAC ID: 4082060785 Enrollment ID: I20231101002827 |
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