Alice S Park, M.D.

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

A94437 Issued in CA

Practice address

9300 Campus Point Dr
Mail Code 0633
La Jolla, CA 92037-1300

Phone

(888) 309-8273

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Anatomic Pathology Physician
  • Murrieta, CA
  • NPI 1588020432
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Bellflower, CA
  • NPI 1043242555
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1093722290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 CAMPUS POINT DR",
            "address_2": "MAIL CODE 0633",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371300",
            "telephone_number": "888-309-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 CAMPUS POINT DR",
            "address_2": "MAIL CODE 0633",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371300",
            "telephone_number": "888-309-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ALICE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "CA",
            "license": "A94437",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A94437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephan Papp, MD
• Stanley Pappelbaum, MD
• Taraneh Paravar, MD
• Edward C Paredez, M.D.
• Mihir Parikh, M.D.
• Jooyoung Park, MD
• Joshua Jinhong Park, PHARMD
• Meredith Park, PHARMD
• Rachael Park, PHARMD
• Samuel Park, PHD

• Reproductive Endocrinology Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Reproductive Endocrinology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.