Provider Demographics
NPI:1699869743
Name:PARK, HYUNKYO (MD)
Entity type:Individual
Prefix:
First Name:HYUNKYO
Middle Name:
Last Name:PARK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 OCONNOR DR STE 28
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1655
Mailing Address - Country:US
Mailing Address - Phone:408-260-3900
Mailing Address - Fax:408-260-3903
Practice Address - Street 1:100 OCONNOR DR STE 28
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1655
Practice Address - Country:US
Practice Address - Phone:408-260-3900
Practice Address - Fax:408-260-3903
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36837207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology