Most Relevant Information
Provider Data
| NPI Number: | 1003204991 |
| Provider Name: | JUDIE PARK |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 9694 |
Most Important Dates
| Enumeration Date: | 12/31/2014 |
| Last Updated: | 12/31/2014 |
Provider Practice Location
7447 SEPULVEDA BLVD
VAN NUYS
CA
914051631
Practice Location Phone/Fax
| Phone: | 8187873400 |
| Fax: |
Provider Mailing Location
7447 SEPULVEDA BLVD
VAN NUYS
CA
914051631
Provider Mailing Phone/Fax
| Phone: | 8187873400 |
| Fax: |