Jaechan Park is a General Practice in Fullerton, California. Jaechan Park practices all healthcare services and medical treatments related to General Practice. The NPI Number for Jaechan Park is 1275666315. The last update date is 2023-03-13.
Jaechan Park's current location address is 614 Inverness Ct, Fullerton, California. You can contact this provider via phone number 6264540159. The mailing address for Jaechan Park is 614 Inverness Ct, Fullerton, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jaechan Park |
|---|---|
| Address | 614 Inverness Ct, Fullerton, California |
| Phone Number | 6264540159 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1275666315 |
|---|---|
| Provider Enumeration Date | 2007-03-14 |
| Last Updated Date | 2023-03-13 |
Provider Mailing Address Detail
| Address | 614 Inverness Ct |
|---|---|
| City | Fullerton |
| State | California (CA) |
| Post Code | 928352776 |
| Phone Number | 6264540159 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 49972 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1687022 | PA | UNITED CONCORDIA | |
| G92988-01 | CA | DENTICAL | |
| 1581480 | AK | -- | |
| B49972-01 | CA | HEALTHY FAMILY | |
| D49972 | CA | DENTICAL-RENDERING ID |
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What is the unique identification code assigned to Jaechan Park by the Centers for Medicare & Medicaid Services?
The Jaechan Park has been issued the NPI (National Provider Identifier) 1275666315. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Jaechan Park located?
The Jaechan Park is located at 614 Inverness Ct, Fullerton, CA 928352776.
What is Jaechan Park's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jaechan Park's area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
On what date did Jaechan Park receive its 1275666315 assignment from the Centers for Medicare & Medicaid Services?
The Jaechan Park was assigned its 1275666315 on 2007-03-14, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Jaechan Park's details last updated?
The information pertaining to the Jaechan Park, including its address, specialty, and other details, was most recently updated on 2023-03-13.
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