Sang Kyu Park

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

49936 Issued in CA

Practice address

421 S la Fayette Park PL Apt 515
Los Angeles, CA 90057-1651

Phone

(213) 215-0650

NPI assigned

Apr 3, 2020

Last updated

Apr 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1245869932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 S LA FAYETTE PARK PL APT 515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571651",
            "telephone_number": "213-215-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S LA FAYETTE PARK PL APT 515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571651",
            "telephone_number": "213-215-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SANG KYU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "49936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Park
• Sandy Park, PHARM.D.
• Sang Park
• Sang Hyo Park, MD
• Sang Jin Park, PHARMACIST
• Sang Woo Park, O.M.D.
• Sangdo Park, MD
• Sangji Emily Park, LMFT
• Sara Soyoung Park, PHARM.D.
• Sarah Eugene Park, MD

• Physical Therapy Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.