Nina J Park, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G081621 Issued in CA

Practice address

14445 Olive View Dr
Medical Administration, 2C138
Sylmar, CA 91342-1437

Phone

(818) 364-1555

NPI assigned

Nov 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles

  dba San Fernando Health Center

  • Clinic/Center
  • San Fernando, CA
  • NPI 1316953532
  NPD

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205903614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "address_2": "MEDICAL ADMINISTRATION, 2C138",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "address_2": "MEDICAL ADMINISTRATION, 2C138",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "818-364-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "NINA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G081621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Palomino
• Maribel Paniagua
• Anais Mariam Panossian
• Albert Park, M.D.
• Elisa M. Park, D.O.
• Sean Parker, MD
• Parrado Inc. (Golden State Manor)
• Joanne Higginson Parrick, CDS
• Partners for Development
• Partovi Dental Inc (Starlet Kids Dental Group & Orthodontics of Sylmar)

• Internal Medicine Physician in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Internal Medicine Physician 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.
• 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.