Eric Song Joon Park in South Lake Tahoe - General Practice
Eric Song Joon Park - NPI 1356560916
Eric Song Joon Park is a General Practice in South Lake Tahoe, California. Eric Song Joon Park practices all healthcare services and medical treatments related to General Practice. The NPI Number for Eric Song Joon Park is 1356560916. The last update date is 2007-07-08.
Eric Song Joon Park's current location address is 2180 Lake Tahoe Blvd, South Lake Tahoe, California. You can contact this provider via phone number 5305413893. The mailing address for Eric Song Joon Park is 2180 Lake Tahoe Blvd, South Lake Tahoe, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Eric Song Joon Park |
|---|---|
| Address | 2180 Lake Tahoe Blvd, South Lake Tahoe, California |
| Phone Number | 5305413893 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1356560916 |
|---|---|
| Provider Enumeration Date | 2007-04-24 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2180 Lake Tahoe Blvd |
|---|---|
| City | South Lake Tahoe |
| State | California (CA) |
| Post Code | 961506418 |
| Phone Number | 5305413893 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 48533 |
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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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What is the Eric Song Joon Park's 1356560916?
The Eric Song Joon Park's NPI (National Provider Identifier) Number is 1356560916. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Eric Song Joon Park's facilities are situated?
The facilities of Eric Song Joon Park are physically located at the following address: 2180 Lake Tahoe Blvd, South Lake Tahoe, CA, 961506418.
What is Eric Song Joon Park's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Eric Song Joon Park is General Practice, and the taxonomy code that categorizes this field of expertise is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services issue the 1356560916 to Eric Song Joon Park?
The Eric Song Joon Park received its 1356560916 assignment from the Centers for Medicare & Medicaid Services on 2007-04-24.
When was the information pertaining to Eric Song Joon Park most recently updated or revised?
The details related to Eric Song Joon Park, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.