Provider Demographics
NPI:1770747305
Name:KAWASAKI, MIZIN PARK (MD)
Entity type:Individual
Prefix:DR
First Name:MIZIN
Middle Name:PARK
Last Name:KAWASAKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:24422 AVENIDA DE LA CARLOTA STE 300
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3628
Mailing Address - Country:US
Mailing Address - Phone:949-599-2434
Mailing Address - Fax:499-599-2430
Practice Address - Street 1:425 HAALAND DR
Practice Address - Street 2:SUITE 104
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-5229
Practice Address - Country:US
Practice Address - Phone:805-494-1948
Practice Address - Fax:805-494-1947
Is Sole Proprietor?:No
Enumeration Date:2008-07-13
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG063471208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics