Most Relevant Information
Provider Data
| NPI Number: | 1003462722 |
| Provider Name: | CAITLYN JEEIN PARK |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC0200X |
| Specialty: | Registered Nurse |
| License Number: | 95160347 |
Most Important Dates
| Enumeration Date: | 08/18/2019 |
| Last Updated: | 07/01/2021 |
Provider Practice Location
7212 ORANGETHORPE AVE STE 9A
BUENA PARK
CA
906214668
Practice Location Phone/Fax
| Phone: | 7145036550 |
| Fax: |
Provider Mailing Location
7212 ORANGETHORPE AVE STE 9A
BUENA PARK
CA
906214668
Provider Mailing Phone/Fax
| Phone: | 7145036550 |
| Fax: |