Yong J Park, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12228T Issued in CA

Practice address

2609 Foothill Blvd
La Crescenta, CA 91214-3511

Phone

(818) 541-0370

Fax

(818) 541-0376

NPI assigned

Jan 8, 2007

Last updated

Jan 28, 2016By the provider in NPPES

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

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1205984317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143511",
            "telephone_number": "818-541-0370",
            "fax_number": "818-541-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143511",
            "telephone_number": "818-541-0370",
            "fax_number": "818-541-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YONG",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12228T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Panosian
• Alexandria Eliza Pardo, OD
• Cynthia Park
• Hannah J Park, DPT
• Mi Ran Park, ACUPUNCTURIST
• Jazel Parkinson, PT, DPT
• Pasadena Integrative Psychiatry
• Kaushik Bansilal Patel
• Maria Hossanah Sales Payumo, MSN, RN CCRN-K
• Pelvicore Physical Therapy PC

• Optometrist in La Crescenta, CA
• Providers in La Crescenta, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.