Individual provider Active NPI

Eugene Park, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1104226935
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A132213 Issued in CA
Practice address
1200 N State St RM 1060H
Lac-Usc Medical Center
Los Angeles, CA 90033-1029
Phone
(323) 226-2828
Fax
(323) 226-6454
NPI assigned
Aug 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A132213 CA Primary

Addresses

Primary practice location

1200 N State St RM 1060H
Lac-Usc Medical Center
Los Angeles, CA 90033-1029

Mailing address

1200 N State St RM 1060H
Lac-Usc Medical Center
Los Angeles, CA 90033-1029
Phone (323) 226-2828

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160927001526 CA Practitioner - Emergency Medicine 5496042954 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 N Vermont Ave
Los Angeles, CA 90027-6098
Phone (310) 379-2134

Hospital & facility affiliations

  • Hollywood Presbyterian Medical Center Hospital, Los Angeles, CA, CCN 050063
  • Corona Regional Medical Center Hospital, Corona, CA, CCN 050329

Merit-based Incentive Payment System (MIPS)

Final score
94.35 of 100Reported as group
Quality
81.59
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
132213CAMDClinical Social Worker
A132213CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corona Regional Emergency Medical Associates Inc Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Telemedicine365 Inc Emergency Medicine CurrentSince Jan 1, 2021 Accepting new patients
Chino Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Jun 25, 2018 Accepting new patients
Tarzana Emergency Medical Associates Emergency Medicine CurrentSince Jun 30, 2017 Accepting new patients
Hollywood Presbyterian Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Jun 25, 2018 Accepting new patients

Locations

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1104226935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST RM 1060H",
            "address_2": "LAC-USC MEDICAL CENTER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-2828",
            "fax_number": "323-226-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST RM 1060H",
            "address_2": "LAC-USC MEDICAL CENTER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-2828",
            "fax_number": "323-226-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-29",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A132213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.