Ji Ah Park

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

PA58548 Issued in CA

Practice address

3325 Palo Verde Ave Ste 105
Long Beach, CA 90808-4132

Phone

(562) 434-7777

NPI assigned

Apr 29, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jiah.park@244638591549444.direct.elationemr.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.

• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  Medicare reassignment Care Compare group
• Prohealth Partners a Medical Group Inc

  • Gastroenterology Physician
  • Long Beach, CA
  • NPI 1750816526
  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD
• Prohealth Partners a Medical Group Inc

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1093848509

  Family Medicine

  NPD (past)
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1639126279
  NPD (past)

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

• Long Beach Memorial Medical

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1962442012
  Care Compare affiliation

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1336703941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 PALO VERDE AVE STE 105",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908084132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 PALO VERDE AVE STE 105",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908084132",
            "telephone_number": "562-434-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JI AH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA58548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Park
• Hannah C Park
• Hyung Bai Park, PT
• Jane Haejin Park
• Jay H Park, MD
• Joy Park, ACSW
• Laura Park
• Lauren Park, PA-C
• Timothy Park, RN
• Stacy L Parker Byone, NURSE PRACTITIONER

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.