Sangae Kim-Park, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28332 Issued in AL

Legal business name

SANGAE KIM-PARK, MD, PC

Practice address

52 Medical Park Dr E
Suite 312
Birmingham, AL 35235-3430

Phone

(205) 702-6602

Fax

(205) 836-3190

NPI assigned

Oct 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Chulwon Park

Title

Executive Director

Phone

(205) 702-6602

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sangae Kim-Park, MD

  • Family Medicine Physician
  • Birmingham, AL
  • NPI 1760679351
  Medicare reassignment NPD

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1053508200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 MEDICAL PARK DR E",
            "address_2": "SUITE 312",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353430",
            "telephone_number": "205-702-6602",
            "fax_number": "205-836-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 MEDICAL PARK DR E",
            "address_2": "SUITE 312",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353430",
            "telephone_number": "205-702-6602",
            "fax_number": "205-836-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANGAE KIM-PARK, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHULWON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-702-6602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "28332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janyce M Sanford, MD
• Julia Gray Sanford, LICSW
• Karina Sanford, CRNP
• Valerie Danette Sanford, CRNP
• Zachary Tyler Sanford, NP
• Matthew Turner Sankey, MD
• Tanya Sanner, MSW, LGSW
• Caylee Gail Sansing, RN
• Alexandra Sansom, RN
• Brendan Sansom, CRNA

• Family Medicine Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.