Andrew Park, DC, CCSP

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC30265 Issued in CA

Practice address

4482 Barranca Pkwy
Suite 192
Irvine, CA 92604-7701

Phone

(949) 552-5094

Fax

(949) 552-5096

NPI assigned

Apr 17, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ganem Chiropractic Professional Corp

  • Chiropractor
  • Irvine, CA
  • NPI 1457463796
  NPD (past)
• Ganem Chiropractic Professional Corporation

  • Chiropractor
  • Irvine, CA
  • NPI 1104968700
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1184840217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 W 9TH ST",
            "address_2": "1",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313436",
            "telephone_number": "714-388-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4482 BARRANCA PKWY",
            "address_2": "SUITE 192",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926047701",
            "telephone_number": "949-552-5094",
            "fax_number": "949-552-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DC, CCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priya Sunil Parikh
• Parisa Behroozi, D.D.S., Inc.
• Park Compounding, Inc.
• Park Place Optometry
• Albert Park, DMD
• Angela Park, NP
• Annie Park, MAOTRL
• Chanwang Park, M.D.
• Che Song Park, M.D.,
• Clayton Park

• Chiropractor in Irvine, CA
• Providers in Irvine, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.