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

Sangdae Park

Individual provider Physical Therapist · NPI 1922543875

Sangdae Park is a Physical Therapist in Sebastopol, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2017
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Practice location Address checks out

556 Lyding Ln
Sebastopol, CA 95472-3311
Phone: (202) 870-0644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 43130 (CA)

Record details

NPI number1922543875
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 2, 2017
Last updated in NPPESJanuary 2, 2017
Mailing address556 Lyding Ln, Sebastopol, CA 95472-3311

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