NPIMap

Individual provider Active NPI

Catherine Y. Park, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1295788016
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A85473 Issued in CA
Practice address
1401 S Grand Ave
Emergency Department
Los Angeles, CA 90015-3010
Phone
(213) 748-2411
NPI assigned
May 19, 2006
Last updated
Jul 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A85473 CA Primary

Addresses

Primary practice location

1401 S Grand Ave
Emergency Department
Los Angeles, CA 90015-3010

Mailing address

PO Box 661748
Arcadia, CA 91066-1748
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
00A854730MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050813000267 CA Practitioner - Emergency Medicine 2769412352 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Irvine, California College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Avenue Emergency Physicians Medical Group IncGroup PAC ID 7315206653, 13 clinicians

Practice addresses (Care Compare)

2215 Truxtun Ave
Bakersfield, CA 93301-3602
Phone (661) 632-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.64 of 100Reported as group
Quality
80.76
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.65
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A85473CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Viejo Emergency Medical Associates Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Mission Viejo Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Emergency Services Medical Corporation Coronado Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Emergency Services Medical Corporation Emergency Medicine CurrentSince Nov 19, 2019 Accepting new patients
Grand Avenue Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince May 31, 2023 Accepting new patients
Pacifica Emergency Medical Associates Emergency Medicine PastSince Nov 15, 2020 Accepting new patients

Locations

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

31872 Coast Hwy
Laguna Beach, CA 92651
Phone (949) 499-1311

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Interoperability endpoints

  • Direct secure messaging: cpark@exer.direct.codonix.com

Organizations & group practices 7

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1295788016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661748",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910661748",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S GRAND AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153010",
            "telephone_number": "213-748-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CATHERINE",
        "middle_name": "Y.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A85473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A854730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.