Provider Demographics
NPI:1588727473
Name:SUNMIN PARK MD A CALIFORNIA MEDICAL CORPORATION
Entity type:Organization
Organization Name:SUNMIN PARK MD A CALIFORNIA MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SUNMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-736-0010
Mailing Address - Street 1:2727 W. OLYMPIC BLVD
Mailing Address - Street 2:SUITE 313
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2699
Mailing Address - Country:US
Mailing Address - Phone:213-736-0010
Mailing Address - Fax:213-736-0020
Practice Address - Street 1:2727 WEST OLYMPIC BLVD
Practice Address - Street 2:SUITE 313
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2699
Practice Address - Country:US
Practice Address - Phone:213-736-0010
Practice Address - Fax:213-736-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74656152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG74656AMedicare ID - Type UnspecifiedMEDICARE PROVIDE
CAG74656Medicare ID - Type UnspecifiedMEDICARE PROVIDER