Won Bo Park DDS Apc

Primary specialty

DentistTaxonomy code 122300000X

License

40048 Issued in CA

Legal business name

WON BO PARK DDS APC

Practice address

1105 S. Euclid St. Suite E
Fullerton, CA 92832

Phone

(714) 738-0304

Fax

(213) 380-2419

NPI assigned

Apr 7, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Joyce Yunsuk Park

Title

Office Manager

Phone

(909) 263-7768

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1669797296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 S. EUCLID ST. SUITE E",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92832",
            "telephone_number": "714-738-0304",
            "fax_number": "213-380-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 S. EUCLID ST. SUITE E",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92832",
            "telephone_number": "714-738-0304",
            "fax_number": "213-380-2419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WON BO PARK DDS APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "YUNSUK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "909-263-7768",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILY",
            "identifier": "40048",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B40048",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ingrid M Wolfe, B.A.
• David Woloz
• Rosalyn Wolpert
• Elexus Denise Womack
• Women'S Transitional Living Center
• Christine Hae-Jin Won, M.D.
• Pamela Won, M.S., CCC-SLP
• Roy Pillsub Won, M.D.
• Amanda Wong, PHARM.D.
• Carly Wong, OTR/L

• Dentist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.