Individual ProviderDonghui ParkStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1303 East Herndon Avenue, Suite 105, Fresno, CA 93720(559) 450-5370(559) 874-5485PECOS EnrollmentBased on the most recent information from CMS, provider Donghui 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 ID1598511024Provider TypeIndividualFull NamePark, DonghuiCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date4/25/2024Last Updated6/27/2024Contact InformationPractice LocationPractice Address1303 East Herndon Avenue, Suite 105, Fresno, CA 93720Phone(559) 450-5370FaxUnlisted FaxMailing LocationMailing Address1303 E Herndon Avenue, Suite 105, Fresno, CA 93720Phone(559) 874-5485FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer