D. J. John Park, M.D., Inc.

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

A98835 Issued in CA

Legal business name

D. J. JOHN PARK, M.D., INC.

Practice address

180 Newport Center Dr Ste 170
Newport Beach, CA 92660-0937

Phone

(949) 777-6883

Fax

(949) 629-4011

NPI assigned

Apr 15, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Dong Jun John Park, M.D.

Title

President

Phone

(714) 326-7715

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1154764694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 NEWPORT CENTER DR STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600937",
            "telephone_number": "949-777-6883",
            "fax_number": "949-629-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NEWPORT CENTER DR STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600937",
            "telephone_number": "949-777-6883",
            "fax_number": "949-629-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 W Stewart Dr Ste 311",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683838",
            "country_code": "US",
            "telephone_number": "714-771-2020",
            "fax_number": "949-629-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "D. J. JOHN PARK, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DONG JUN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-326-7715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "CA",
            "license": "A98835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmologic Surgery Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Ophthalmologic Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.