Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jongho Park

Individual provider Pharmacist · NPI 1043857162

Jongho Park is a Pharmacist in San Rafael, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2019

Practice location Address checks out

442 Las Gallinas Ave
San Rafael, CA 94903-3618
Phone: (415) 479-9171
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence RPH81423 (CA)

Record details

NPI number1043857162
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 9, 2019
Last updated in NPPESDecember 9, 2019
Certification dateDecember 9, 2019
Mailing address442 Las Gallinas Ave, San Rafael, CA 94903-3618

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