Active NPI
Dai Park, M.D.
- Allergy & Immunology Physician
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- A101619
- Practice address
- 600 Coffee Rd
Modesto, CA 95355-4201 - Phone
- (209) 521-6097
- NPI assigned
- May 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 45278 | TN | |
| Internal Medicine Physician | 207R00000X | A101619 | CA | |
| Allergy & Immunology Physician | 207K00000X | A101619 | CA | Primary |
Addresses
Primary practice location
600 Coffee Rd
Modesto, CA 95355-4201
Mailing address
600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- University of Texas Southwestern Medical School at Dallas, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
123 S San Mateo Dr
San Mateo, CA 94401-3804
Phone (650) 343-4200
1720 El Camino Real
Burlingame, CA 94010-3225
3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A101619 | CA | MD | Allergy & Immunology Physician |
| 45278 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baz Allergy, Asthma & Sinus Center, Inc. | Current | Accepting new patients | |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Baz Allergy, Asthma & Sinus Center | Current | Accepting new patients | |
| Baz Allergy, Asthma & Sinus Center, Inc. | Current | Accepting new patients | |
| Permanente Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Permanente Medical Group, Inc | Current | Accepting new patients | |
| Permanente Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter Bay Medical Foundation | Internal Medicine | Current | Accepting new patients |
| Sutter Gould Medical Foundation | Internal Medicine | Past | Accepting new patients |
| Sutter East Bay Medical Foundation | Internal Medicine | Past | Accepting new patients |
| Doctors Medical Center of Modesto, Inc. | Past | Accepting new patients |
Locations (25 of 36)
18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
4000 Dublin Blvd
Dublin, CA 94568
Phone (510) 498-2374
4000 Dublin Blvd
Fl 2
Dublin, CA 94568
1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100
3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800
7471 N Fresno St
Fresno, CA 93720
Phone (559) 436-4500
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977
370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200
1415 Badger Flat Rd
Ste A
Los Banos, CA 93635
Phone (209) 710-8684
4601 Dale Rd
Modesto, CA 95356
Phone (209) 557-1000
600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755
1923 Coffee Rd
Ste 12C
Modesto, CA 95355
Phone (209) 409-8454
101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200
795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832
101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109
1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505
3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847
Interoperability endpoints
- dpark126731@hisp.ehr.sutterhealth.org
Organizations & group practices 12
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.
-
- Multi-Specialty Clinic/Center
- Palo Alto, CA
- NPI 1013950807
-
- Allergy Physician
- Fresno, CA
- NPI 1710906995
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
-
- Allergy Physician
- Clovis, CA
- NPI 1396328779
-
- Allergy Physician
- Modesto, CA
- NPI 1265812119
-
- Internal Medicine Physician
- Stockton, CA
- NPI 1548343510
-
- Clinical Medical Laboratory
- San Jose, CA
- NPI 1497971584
-
- Multi-Specialty Clinic/Center
- Sacramento, CA
- NPI 1003267196
Internal Medicine
-
- Clinical Medical Laboratory
- Santa Clara, CA
- NPI 1669287033
-
- General Acute Care Hospital
- Modesto, CA
- NPI 1184654923
-
- Family Medicine Physician
- Orinda, CA
- NPI 1871538769
Internal Medicine
-
- Family Medicine Physician
- Turlock, CA
- NPI 1023065133
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640131200000",
"number": "1376744896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554201",
"telephone_number": "209-521-6097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554201",
"telephone_number": "209-521-6097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "DAI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "45278",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A101619",
"primary": false
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "CA",
"license": "A101619",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4601 Dale Rd",
"city": "Modesto",
"state": "CA",
"country_code": "US",
"postal_code": "953569718",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.