Serena Park

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

301058 Issued in CA

Practice address

14221 Euclid St Ste F
Garden Grove, CA 92843-4991

Phone

(714) 891-2739

NPI assigned

Nov 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dynamik Rehab Inc

  • Physical Therapist
  • Garden Grove, CA
  • NPI 1720806417
  NPD
• Dynamix Physical Therapy Inc.

  • Physical Therapist
  • Westminster, CA
  • NPI 1538288204
  NPD

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1356006308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 CORDELIA CT",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906218436",
            "telephone_number": "714-520-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14221 EUCLID ST STE F",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434991",
            "telephone_number": "714-891-2739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58 Cordelia Ct",
            "address_purpose": "LOCATION",
            "city": "Buena Park",
            "state": "CA",
            "postal_code": "906218436",
            "country_code": "US",
            "telephone_number": "714-520-1747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SERENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Park, DPT
• Jun Gyu Park, DDS
• Kideog Park
• Sanghoon Park, DDS
• Seonho Park
• Stephen S Park, MD
• Steven Park
• Sue Park, LAC
• Tracy Tom Park, O.D.
• We Sun Park

• Physical Therapist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.