Joong Young Park M.D. Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A39059 Issued in CA

Legal business name

JOONG YOUNG PARK M.D. INC.

Practice address

9535 Garden Grove Blvd Ste 104
Garden Grove, CA 92844-1551

Phone

(714) 534-1112

Fax

(714) 534-1116

NPI assigned

Oct 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Joong Young Park, M.D.

Title

President

Phone

(714) 534-1112

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Joong Y Park, MD

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1003839002
  NPD (past)

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1104014034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9535 GARDEN GROVE BLVD STE 104",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441551",
            "telephone_number": "714-534-1112",
            "fax_number": "714-534-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9535 GARDEN GROVE BLVD STE 104",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441551",
            "telephone_number": "714-534-1112",
            "fax_number": "714-534-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOONG YOUNG PARK M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JOONG YOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-534-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A39059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A390590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara Jones, B.S.
• Thomas Joseph Jones IV
• Jongro Medical Supply Inc
• Victoria Joo
• Joong Y Park M D Medical Corp
• Victor Jordan
• Joshua Jorge
• Jose Miranda MD Inc.
• Joshua House, LLC
• Jennymarie Danielle Jost

• General Practice Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.