Dr. Lisa L Park
MD | Pediatric Adolescent Medicine | Female
Dr. Lisa L Park, MD is a Fairfax, Virginia based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Dr. Lisa L Park is
4400 University Dr, Student Union Building 1, Room 2300, Fairfax, Virginia - 22030-4422. She can be contacted on phone at
703-993-2831 and fax number 703-993-4365.
Dr. Lisa L Park is a sole proprietor of her business.
NPI number (Unique professional ID) for Dr. Lisa L Park is
1699982868 which was assigned by NPPES on 17 May, 2007 and it was last updated on 11 Jan, 2012.
Dr. Lisa L Park license number is
0101250887 for Pediatrics Adolescent Medicine (2080A0000X) in Virginia.
Dr. Lisa L Park specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Dr. Lisa L Park basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Dr. Lisa L Park |
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| Credential : | MD |
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| Gender : | Female |
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Business Address:
Dr. Lisa L Park address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 4400 University Dr, Student Union Building 1, Room 2300
Fairfax, VA, 22030-4422
United States |
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| Phone Number : | 703-993-2831 |
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| Fax Number : | 703-993-4365 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1699982868 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 17 May, 2007 |
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| Last Updated On : | 11 Jan, 2012 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Lisa L Park are as mentioned. Primary taxonomy code for Dr. Lisa L Park, MD is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080A0000X | Pediatrics Adolescent Medicine | No | 25MA08646300 | NJ |
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 0101250887 | VA |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 4400 University Dr, Student Union Building 1, Room 2300
Fairfax, VA, 22030-4422
United States |
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| Phone Number : | 703-993-2831 |
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| Fax Number : | 703-993-4365 |
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Business Location:
Patients can refer following map for directions to
Dr. Lisa L Park practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.