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PARK, KWANG SOO       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: HOLLYWOOD MENTAL HLTH CTR
1224 VINE STREET
LOS ANGELES CA 90038

Address last updated on 1/6/2014
Phone #: (323) 769-6100
Fax #: (32) 346-0297
County: NOT OKLAHOMA
License: 13032
Dated: 3/17/1981
Expires: 3/1/2016
License Type: Medical Doctor
Specialty: Psychiatry
Status: Inactive
Status Class: Physician Emeritus
Restricted to:
Registered to Dispense: NO
Medical School: Korea Univ Coll Of Med, Chong-No-Ku, Seoul, So Korea
Graduated: 2 / 1973
CME Year: 2016
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
HOLLYWOOD MENTAL HLTH CTR
1224 VINE STREET
LOS ANGELES CA 90038

Phone #: (323) 769-6100
Fax #: (32) 346-0297

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