Woori Medical Group Professional Corp

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

C51913 Issued in CA

Legal business name

WOORI MEDICAL GROUP PROFESSIONAL CORP

Practice address

7825 Engineer Rd
Ste 101
San Diego, CA 92111-1924

Phone

(858) 277-7111

Fax

(858) 277-7667

NPI assigned

Jul 31, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Ro Jong Park, M.D.NPI 1699799593

Title

President

Phone

(858) 277-7111

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

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

• Ro Jong Park, MD

  • Surgery Physician
  • San Diego, CA
  • NPI 1699799593

  General Practice

  Medicare reassignment Care Compare group NPD Authorized official
• Jessica Seungeun Baik, MD

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1386168821

  General Practice

  Medicare reassignment Care Compare group NPD
• Choon Soo Rim, MD

  • Neurology Physician
  • San Diego, CA
  • NPI 1083827273
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1275764706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 ENGINEER RD",
            "address_2": "STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111924",
            "telephone_number": "858-277-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 ENGINEER RD",
            "address_2": "STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111924",
            "telephone_number": "858-277-7111",
            "fax_number": "858-277-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOORI MEDICAL GROUP PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-31",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "RO",
        "authorized_official_middle_name": "JONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-277-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C51444",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "C51913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275764706",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian David Woolford, MD
• Lauren Woolley, PHD
• Scott Roland Woolley, PHD
• Julie Woolridge, DPT
• Emily Woolsey, NP
• Collen Edward Wooten, PT, DPT
• Tramesha Alena Wooten
• Wilma Jean Wooten, M.D.
• Wendy Worbington
• Jordyn Worby, RD

• General Practice Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.