Search › California › 163W00000X
Ellie Park
NPI 1639711880 · on the registry since 2019 · sole proprietor
Practice
- Address
- 16450 Veterans Way Unit 203
Tustin, CA 92782 - Phone
- (917) 532-0537
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-09-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California