Eun Kyung Park, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95007780 Issued in CA

Practice address

209 W Alameda Ave Ste 101
Burbank, CA 91502-3023

Phone

(866) 227-3310

NPI assigned

Feb 27, 2018

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Ans Medical Group

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1124865795
  Medicare reassignment NPD
• Integrated Allied Medical Group

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1649970740
  Medicare reassignment NPD
• New Heights Medical Group

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1215501077
  Medicare reassignment
• California Mobile Medical Group Inc

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1588439061
  NPD (past)

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1194226936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S ARDMORE AVE APT 234",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203162",
            "telephone_number": "213-458-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W ALAMEDA AVE STE 101",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915023023",
            "telephone_number": "866-227-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "EUN",
        "middle_name": "KYUNG",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95007780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF NURSING",
            "identifier": "95007780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Paredes, D.P.T.
• Rene Paredes
• Paresh N Varu M D Inc
• Manisha Parikh, LCSW
• Christie Park
• Joseph Park, DPM
• Patti J Park, LCSW
• Scott Park
• Wonsun Park
• Samuel Parker

• Gerontology Nurse Practitioner in Burbank, CA
• Providers in Burbank, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.