Active NPI
Daniel Won Park, PT, DPT
- Physical Therapist
- Lynwood, CA
National Provider Identifier
1104705664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 308582
- Practice address
- 3630 E Imperial Hwy
Lynwood, CA 90262 - Phone
- (310) 900-8900
- NPI assigned
- Aug 29, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 308582 | CA | Primary |
Addresses
Primary practice location
3630 E Imperial Hwy
Lynwood, CA 90262
Mailing address
PO Box 01796
Los Angeles, CA 90001
Phone (562) 536-3184
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308582 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756425600000",
"number": "1104705664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 01796",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90001",
"telephone_number": "562-536-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3630 E IMPERIAL HWY",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "90262",
"telephone_number": "310-900-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "DANIEL",
"middle_name": "WON",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-29",
"last_updated": "2025-08-29",
"certification_date": "2025-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "308582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.