Jae Park

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

ACU1249 Issued in HI

Practice address

320 Ward Ave Ste 205
Honolulu, HI 96814-4017

Phone

(808) 840-0556

NPI assigned

Oct 12, 2018

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beautymed Therapy

  • Acupuncturist
  • Honolulu, HI
  • NPI 1184107740
  NPD (past)

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1285109504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WARD AVE STE 205",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144017",
            "telephone_number": "808-840-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WARD AVE STE 205",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144017",
            "telephone_number": "808-840-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-12",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "HI",
            "license": "ACU1249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gavin H Park
• Grace Park, SLP-CCC
• Han Park, M.D.
• Harry Park, CRNA
• Hee Jung Park, M.D.
• James Eun Park, MASSAGE THERAPIST
• Jang B. Park, M.D.
• Jenna Sohee Park
• Jennifer Park
• Jihyun Park, MD

• Acupuncturist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Acupuncturist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.