Provider Demographics
NPI:1265283303
Name:PARK, SUNG MEE (MD)
Entity type:Individual
Prefix:
First Name:SUNG MEE
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUNGMEE
Other - Middle Name:
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17732 PENNACOOK CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1369
Mailing Address - Country:US
Mailing Address - Phone:858-776-3694
Mailing Address - Fax:
Practice Address - Street 1:17732 PENNACOOK CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1369
Practice Address - Country:US
Practice Address - Phone:858-776-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program