Neurological Medical Group of Orange County Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

20A7365 Issued in CA

Legal business name

NEUROLOGICAL MEDICAL GROUP OF ORANGE COUNTY INC

Practice address

12555 Garden Grove Blvd
Suite 305
Garden Grove, CA 92843-1902

Phone

(714) 636-7844

Fax

(714) 847-7396

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James J Park, D.ONPI 1306871421

Title

President

Phone

(714) 636-7844

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• James Jongtak Park, D.O.

  • Neurology Physician
  • Huntington Beach, CA
  • NPI 1306871421
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1366463358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FLORA SPGS",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926022412",
            "telephone_number": "714-847-7392",
            "fax_number": "714-847-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 GARDEN GROVE BLVD",
            "address_2": "SUITE 305",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431902",
            "telephone_number": "714-636-7844",
            "fax_number": "714-847-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL MEDICAL GROUP OF ORANGE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-636-7844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A7365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL I.D NUMBER",
            "identifier": "00AX73650",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1306871421",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID",
            "identifier": "ZZZ04904Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "W20108",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Negin Behazin MD, a Med Corp
• Harold Nelson, P.T.
• Melanie C Nelson, LCSW
• Robert L Nelson, M.D.
• Russell L. Ness, MD
• Samantha Berlen Nevarez
• New Bridge Inc.
• New Hope Pharma Inc
• New Hope Therapy Center
• New Life Adult Day Health Care Center - Garden Grove

• Neurology Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.