Rack Joon Park | Tustin, CA • PECOS Search

Rack Joon Park

Acupuncturist

Other Service Providers

14151 Newport Ave, Suite 102, Tustin, CA 92780-5163

(714) 838-8931 (714) 866-6545

PECOS Enrollment

Based on the most recent information from CMS, provider Rack Joon Park does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1659712487
Provider Type
Individual
Full Name
Park, Rack Joon
Credential
L.AC

Gender
Male
Sole Proprietor
Yes
Enumeration Date
7/9/2013
Last Updated
7/9/2013

Contact Information

Practice Location

14151 Newport Ave, Suite 102, Tustin, CA 92780-5163

Unlisted Fax

Mailing Location

616 Wycliffe, Irvine, CA 92602-1214

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171100000X Primary	Description Acupuncturist Other Service Providers	License AC12816 California