Jaeyong Park, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

13211 Issued in CA

Practice address

2896 Treeview PL
Fullerton, CA 92835-3142

Phone

(714) 726-1914

NPI assigned

Sep 8, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1003149105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2896 TREEVIEW PL",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353142",
            "telephone_number": "714-726-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2896 TREEVIEW PL",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353142",
            "telephone_number": "714-726-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAEYONG",
        "name_prefix": "Mr.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "13211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie M. Park, O.D.
• David J Park, M.D.
• Eugene Park, L.AC.
• Gene Hyounglin Park, D.D.S., M.S.
• Heejin Park
• James Keonuk Park, D.D.S.
• Janice Hyejin Park, PHARMD
• Jennifer Park
• Ji Yong Park, DDS
• Jin Woo Park, AC

• Acupuncturist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.