Royal Son Park, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A79808 Issued in CA

Practice address

23600 Telo Ave Ste 220
Torrance, CA 90505-4039

Phone

(310) 602-5005

Fax

(310) 373-7895

NPI assigned

May 18, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

New York University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: royal.park.1@3663.direct.athenahealth.com

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.

• Genesis Healthcare Partners PC

  • Specialist
  • Encinitas, CA
  • NPI 1548567498
  Medicare reassignment Care Compare group NPD
• Urology Institute of the South Bay

  • Urology Physician
  • Torrance, CA
  • NPI 1801804760
  NPD
• Torrance Memorial Medical Center

  • Skilled Nursing Facility
  • Torrance, CA
  • NPI 1740268713
  NPD (past)

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

• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1336192301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 LOMITA BLVD STE B",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055118",
            "telephone_number": "424-220-6388",
            "fax_number": "424-285-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23600 TELO AVE STE 220",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054039",
            "telephone_number": "310-602-5005",
            "fax_number": "310-373-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ROYAL",
        "middle_name": "SON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A79808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A798080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Mijin Park
• Kenneth Park, M.D.
• Michelle Park
• Michelle Park, M.D.
• Michelle Hansol Park, PHARM.D
• Sa Nan Park, MD, MPH
• Steven Yong Park, D.M.D.
• Susan Kyung Park, MD MPH
• Valentina Park, MD
• Vincent Anthony Park

• Urology Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.