Esther Park, D.O., LLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

20A7734 Issued in CA

Legal business name

ESTHER PARK, D.O., LLC

Practice address

1101 Dove St
Suite 130
Newport Beach, CA 92660-2844

Phone

(949) 258-3741

Fax

(949) 258-3742

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Paul Kim

Title

Office Manager

Phone

(949) 258-3741

Specialties & licenses 1

Addresses

Other names 1

• Park Psychiatry, LLC Doing business as

Locations

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1104002096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 DOVE ST",
            "address_2": "SUITE 130",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602844",
            "telephone_number": "949-258-3741",
            "fax_number": "949-258-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 DOVE ST",
            "address_2": "SUITE 130",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602844",
            "telephone_number": "949-258-3741",
            "fax_number": "949-258-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTHER PARK, D.O., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-258-3741",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "20A7734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Psychiatry, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Child & Adolescent Psychiatry Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.