Jenny Park Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

14630 Issued in CA

Legal business name

JENNY PARK OPTOMETRY

Practice address

6600 Topanga Canyon Blvd Unit 1
Canoga Park, CA 91303-2601

Phone

(818) 883-8220

NPI assigned

Oct 7, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jenny ParkNPI 1356752372

Title

Optometrist

Phone

(206) 446-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jenny Park Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jenny Park, O.D.

  • Optometrist
  • Canoga Park, CA
  • NPI 1356752372
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1235689779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 TOPANGA CANYON BLVD UNIT 1",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 TOPANGA CANYON BLVD UNIT 1",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032601",
            "telephone_number": "818-883-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNY PARK OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "206-446-2800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1356752372",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jenny Park Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ahmad Javaid
• Jay J Lin MD Inc a Prof Corp
• Karim Jazaerle
• Jelini Dental Corporation
• Fatima Bala Jelini, DDS
• Jeremy Ian Grosser MD Inc.
• Jeremy Ian Grosser, M.D., Inc.
• Jeri B Munn DDS Apdc
• Zachary Jeronimus
• Kajol Jewan, OD

• Optometrist in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.