SE Ryung Park

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

11324 Issued in CA

Practice address

15541 Williams St Apt D4
Tustin, CA 92780-4191

Phone

(714) 902-5959

NPI assigned

Nov 15, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1275178055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15541 WILLIAMS ST APT D4",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804191",
            "telephone_number": "714-902-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15541 WILLIAMS ST APT D4",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804191",
            "telephone_number": "714-902-5959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1440 S Anaheim Blvd # G1",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928056213",
            "country_code": "US",
            "telephone_number": "714-340-6590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SE",
        "middle_name": "RYUNG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "11324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe W Park, DC, CCSP
• John Park, DC
• Jumi Park
• Paul Park, LMFT
• Rack Joon Park, L.AC
• Michelle Christine Parsons, DPT, PT, ATC
• Harshini Paruchuru, DDS
• Joseph Pascal
• Mary Pasdar, RNP
• Marjan Pashaei Jamalpour, SLPA

• Acupuncturist in Tustin, CA
• Providers in Tustin, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.