Individual ProviderKathy Won ParkNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address757 Westwood Plz, Los Angeles, CA 90095-2644(310) 301-6800PECOS EnrollmentBased on the most recent information from CMS, provider Kathy Won 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 11 days ago.Profile DetailsProvider ID1760780654Provider TypeIndividualFull NamePark, Kathy WonTitleMrs.CredentialN.P.GenderFemaleSole ProprietorNoEnumeration Date3/2/2011Last Updated2/6/2024Contact InformationPractice LocationPractice Address757 Westwood Plz, Los Angeles, CA 90095-2644Phone(310) 301-6800Fax(310) 794-9035Mailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense12601California