Eil B Park, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

013746 Issued in ME

Practice address

1703 Escada
San Antonio, TX 78258-4531

Phone

(210) 408-1004

Fax

(210) 408-1004

NPI assigned

Feb 20, 2007

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Milwaukee VA Medical Center

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1780724161
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366587156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 ESCADA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584531",
            "telephone_number": "210-408-1004",
            "fax_number": "210-408-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 ESCADA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584531",
            "telephone_number": "210-408-1004",
            "fax_number": "210-408-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "EIL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "013746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Infusioncare, L.P.
• Park Infusioncare, LP
• Park Oaks Dental
• Debra J Park, RRT
• Deukhyun Park
• Eric Geonkyu Park
• In Seok Park, MD
• Jacob Gyeongil Park, D.D.S.
• Jeena Shinyoung Park
• Jinhee Park

• Diagnostic Radiology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.