Stephen Park, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

G55543 Issued in CA

Practice address

1900 Sullivan Ave
Daly City, CA 94015-2200

Phone

(650) 991-0600

Fax

(650) 991-0306

NPI assigned

Jul 7, 2006

Last updated

Mar 24, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1831268580
  Medicare reassignment NPD
• Stephen Park MD

  • Pulmonary Disease Physician
  • Daly City, CA
  • NPI 1861882144
  NPD (past) Authorized official
• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• Cogent Healthcare of Daly City, P.C.

  • Internal Medicine Physician
  • Daly City, CA
  • NPI 1568794881
  NPD (past)
• Daly City Hospitalist Group, Inc.

  • General Acute Care Hospital
  • Daly City, CA
  • NPI 1932374501
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1124050505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 VIRGINIA AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022236",
            "telephone_number": "650-455-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SULLIVAN AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152200",
            "telephone_number": "650-991-0600",
            "fax_number": "650-991-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "STEPHEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G55543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Jo Pao, OD
• Theodor Stephen Parada, M.D.
• Josephine Paras, OTR/L
• Shannon Paras
• Jessie Picazo Pardilla
• Jensonmar Enrico Parreno
• Alisha Parrish, MS
• Daniel David Parry, M.D.
• Lobsang Tsering Partsang
• Ma Katrina Isabelle Franco Pascua

• Pulmonary Disease Physician in Daly City, CA
• Providers in Daly City, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.