Jung Min Park, LIC. AC.

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

License

2933 Issued in CO

Practice address

2685 S Dayton Way
#306
Denver, CO 80231-3958

Phone

(720) 244-8512

NPI assigned

Apr 11, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1124291018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 S DAYTON WAY",
            "address_2": "#306",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802313958",
            "telephone_number": "720-244-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 S DAYTON WAY",
            "address_2": "#306",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802313958",
            "telephone_number": "720-244-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNG MIN",
        "credential": "LIC. AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "1743",
            "primary": false
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "CO",
            "license": "2933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Surgery Center LLC
• Ashley Park
• Ashley Park, MA, LPCC, ATR-P
• Eun Chil Park, M.D.
• Hwajin Park
• Jung Yeon Park, M.D.
• Samuel Park, DPT
• Suegie Park, PHARM. D.
• Tony J Park, M.D.
• Youngju Park, CCC-SLP

• Electroneurodiagnostic Specialist/Technologist in Denver, CO
• Providers in Denver, CO by specialty
• Electroneurodiagnostic Specialist/Technologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.