Che Song Park, M.D.,

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

4301031253 Issued in MI

Practice address

3500 Barranca Pkwy
Suite 330
Irvine, CA 92606-8226

Phone

(949) 552-8217

Fax

(949) 809-9514

NPI assigned

Aug 31, 2006

Last updated

Feb 24, 2011By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Saginaw Colon and Rectal Surgery,PC

  • Specialist
  • Saginaw, MI
  • NPI 1831200500
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1316058076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 BARRANCA PKWY",
            "address_2": "SUITE 330",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926068226",
            "telephone_number": "949-552-8217",
            "fax_number": "949-809-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 BARRANCA PKWY",
            "address_2": "SUITE 330",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926068226",
            "telephone_number": "949-552-8217",
            "fax_number": "949-809-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHE SONG",
        "name_prefix": "Mr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "MI",
            "license": "4301031253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "280739862",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS",
            "identifier": "2898621",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Albert Park, DMD
• Andrew Park, DC, CCSP
• Angela Park, NP
• Annie Park, MAOTRL
• Chanwang Park, M.D.
• Clayton Park
• Eunice Park
• Eunyung Park, DDS
• Hyungwook Park
• Jae H Park, D.C.

• Legal Medicine in Irvine, CA
• Providers in Irvine, CA by specialty
• Legal Medicine in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.