Wilshire Cardiology Group, a Professional Corporation

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

WILSHIRE CARDIOLOGY GROUP, A PROFESSIONAL CORPORATION

Doing business as

Wilshire Cardiology Group, Inc.

Practice address

500 S Virgil Ave
Ste. 200
Los Angeles, CA 90020-1446

Phone

(213) 387-8000

Fax

(213) 769-5004

NPI assigned

Sep 2, 2010

Last updated

Dec 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steve Seekook Park, M.D.

Title

Owner

Phone

(213) 387-8000

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Wilshire Cardiology Group, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• DO Hee Kim, MD

  • Nuclear Medicine Physician
  • Los Angeles, CA
  • NPI 1346542263
  Medicare reassignment Care Compare group NPD
• Steve Seekook Park, M.D.

  • Cardiovascular Disease Physician
  • Los Angeles, CA
  • NPI 1649202698
  Medicare reassignment Care Compare group NPD
• Ali Golshan, M.D.

  • Vascular & Interventional Radiology Physician
  • Beverly Hills, CA
  • NPI 1114183993
  Medicare reassignment NPD
• Prabhjot Kaur Grewal, MD

  • Vascular Surgery Physician
  • Riverside, CA
  • NPI 1770748030
  Medicare reassignment NPD
• Sara Jean Runge, M.D.

  • Vascular Surgery Physician
  • Long Beach, CA
  • NPI 1740414606
  Medicare reassignment NPD
• Eun Young Kim, NP

  • Nurse Practitioner
  • Los Angeles, CA
  • NPI 1689058836
  NPD
• Eunsook Kim

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1295464469
  NPD
• Paul Hyundo Lee, FNP

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1437070406
  NPD (past)
• David Chien, M.D.

  • Nuclear Medicine Physician
  • Pittsburgh, PA
  • NPI 1245437250
  NPD (past)
• Back Kyun Kim, MD

  • Cardiovascular Disease Physician
  • Flushing, NY
  • NPI 1699833327
  NPD (past)

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1366759904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S VIRGIL AVE",
            "address_2": "STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201446",
            "telephone_number": "213-387-8000",
            "fax_number": "213-387-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S VIRGIL AVE",
            "address_2": "STE. 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201446",
            "telephone_number": "213-387-8000",
            "fax_number": "213-769-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIRE CARDIOLOGY GROUP, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "STEVE SEEKOOK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-387-8000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G714481",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060061949",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PIN",
            "identifier": "2973727",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilshire Cardiology Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wilshire Cardiology Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney M Wilmot, NURSE PRACTITIONER
• Wilshire Aesthetics Medical Associates Surgery Center, Inc.
• Wilshire Aesthetics Medical Associates, Inc.
• Wilshire Anesthesia Associates LLC
• Wilshire Anesthesia Associates LLC
• Wilshire Center for Ambulatory Surgery, Inc.
• Wilshire Center for Cosmetic Surgery, a Professional Corporation
• Wilshire Center for Dermatology, a Professional Corporation
• Wilshire Co Medical Group Inc
• Wilshire Dermatology Medical Group, Inc.

• Cardiovascular Disease Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.