IndividualActive
Jin Park, M.D.
NPI 1306824909 · Pediatric Cardiology Physician · Fairfax, VA
Provider details
- NPI number
- 1306824909
- Entity type
- Individual
- Primary specialty
- Pediatric Cardiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 0101232879 (VA)
Practice location
8500 Executive Park Ave Ste 110
Fairfax, VA 22031-2228
Phone: (703) 573-0504
Fax: (703) 573-4856
Mailing address
8500 Executive Park Ave
Fairfax, VA 22031-2225
Registry dates
- Enumerated
- 2006-01-04
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.