Individual ProviderJohn ParkInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4867 W Sunset Blvd, Los Angeles, CA 90027-5969(833) 574-2273(323) 821-8012PECOS EnrollmentBased on the most recent information from CMS, provider John Park is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1851823504Provider TypeIndividualFull NamePark, JohnCredentialMDGenderMaleSole ProprietorYesEnumeration Date3/31/2017Last Updated12/23/2021Contact InformationPractice LocationPractice Address4867 W Sunset Blvd, Los Angeles, CA 90027-5969Phone(833) 574-2273FaxUnlisted FaxMailing LocationMailing Address4867 Sunset Blvd, 6th Floor Hospitalist Office, Los Angeles, CA 90027-5969Phone(323) 821-8012FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA157957California