Sangdo Park, M.D., a Professional Corporation

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

A107642 Issued in CA

Legal business name

SANGDO PARK, M.D., A PROFESSIONAL CORPORATION

Practice address

2105 Beverly Blvd
Suite 223
Los Angeles, CA 90057-2216

Phone

(213) 989-0644

NPI assigned

Sep 10, 2012

Organization subpart

No

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

Authorized official

Name

Sangdo Park, M.D.NPI 1164582656

Title

Owner

Phone

(213) 989-0644

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sangdo Park, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Los Angeles, CA
  • NPI 1164582656
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1346590098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "SUITE 223",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-989-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "SUITE 223",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-989-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANGDO PARK, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SANGDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-989-0644",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A107642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Bayaya Sangalang, PT
• Ria Venessa Ivy Daya Sangalang
• Rauvynne Neena Sangara, M.D.
• Morgan J Sangare, LMT
• Rowena Sangco
• Sangduk Oh, DDS, Inc
• Bikramjit S. Sangha, MD
• Gurleen Kaur Sangha
• Manreet Sangha, DPT
• John Sangmoah

• Sports Medicine (Orthopaedic Surgery) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.