Individual ProviderJung Kyo ParkAcupuncturistOther Service ProvidersPractice Address2001 S Barrington Ave, Suite 212, Los Angeles, CA 90025-5363(213) 444-1155PECOS EnrollmentBased on the most recent information from CMS, provider Jung Kyo Park does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1023392792Provider TypeIndividualFull NamePark, Jung KyoGenderMaleSole ProprietorYesEnumeration Date9/29/2011Last Updated12/3/2014Contact InformationPractice LocationPractice Address2001 S Barrington Ave, Suite 212, Los Angeles, CA 90025-5363Phone(213) 444-1155Fax(213) 402-5183Mailing LocationMailing Address20435 S Vermont Ave, Unite 2, Torrance, CA 90502-3150Phone(213) 444-1155Fax(213) 402-5183Provider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicense14491California