Sangdo Park is a Sports Medicine in Los Angeles, California. Sangdo Park practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Sangdo Park is 1164582656. The last update date is 2012-10-24.
Sangdo Park's current location address is 2105 Beverly Blvd, Los Angeles, California. You can contact this provider via phone number 2139890644. The mailing address for Sangdo Park is 2105 Beverly Blvd, Los Angeles, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Sangdo Park |
|---|---|
| Address | 2105 Beverly Blvd, Los Angeles, California |
| Phone Number | 2139890644 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1164582656 |
|---|---|
| Provider Enumeration Date | 2006-12-12 |
| Last Updated Date | 2012-10-24 |
Provider Mailing Address Detail
| Address | 2105 Beverly Blvd |
|---|---|
| City | Los Angeles |
| State | California (CA) |
| Post Code | 900572216 |
| Phone Number | 2139890644 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
| Licence No | N6562 |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8W9051 | TX | BCBS | |
| 8CR159 | TX | BC/BS TX - EFFECT. 02/01/2011 | |
| P00935331 | TX | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Sangdo Park by the Centers for Medicare & Medicaid Services?
The Sangdo Park has been assigned the NPI (National Provider Identifier) 1164582656 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Sangdo Park's facilities are geographically located?
The facilities of Sangdo Park are physically situated at the following location: 2105 Beverly Blvd, Los Angeles, CA, 900572216.
What is Sangdo Park's specialized field of practice, and what is the corresponding taxonomy classification code?
The Sangdo Park's area of specialization is Sports Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Xx0005X.
On what date did the Sangdo Park receive the assignment of its 1164582656 from the Centers for Medicare & Medicaid Services?
The Sangdo Park was issued its 1164582656 by the Centers for Medicare & Medicaid Services on 2006-12-12.
As of what date were the Sangdo Park's details last updated?
The information pertaining to the Sangdo Park, including its address, specialty, and other details, was most recently updated on 2012-10-24.