Chang Sik Park, L AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC3907 Issued in CA

Practice address

100 E Thousand Oaks Blvd Ste 250
Thousand Oaks, CA 91360-8150

Phone

(805) 495-0360

Fax

(805) 495-2707

NPI assigned

Nov 27, 2006

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

Other identifiers 1

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174699763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E THOUSAND OAKS BLVD STE 250",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608150",
            "telephone_number": "805-495-0360",
            "fax_number": "805-495-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E THOUSAND OAKS BLVD STE 250",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608150",
            "telephone_number": "805-495-0360",
            "fax_number": "805-495-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHANG",
        "middle_name": "SIK",
        "name_prefix": "Mr.",
        "credential": "L AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC3907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER IDENTIFICATION #",
            "identifier": "0770272019",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Mary Pantelas, M.A., BCBA
• Michael Nicholas Papanicolaou, M.D.
• Jonathan Pappas, LMFT 90331
• Paradise Plus Care Transportation, Inc
• Tiffany Paris
• Euijeong Park, L.AC.
• Eunice Park, BA
• Jee Hoon Park, MD
• Jin Man Park
• Rachel Park

• Acupuncturist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.