Active NPI
Johnny Park, HAD
- Hearing Instrument Specialist
- Los Angeles, CA
National Provider Identifier
1396015152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 7708
- Practice address
- 1058 S Vermont Ave
Suite 109
Los Angeles, CA 90006-2721 - Phone
- (213) 368-6300
- NPI assigned
- Jan 10, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 7708 | CA | Primary |
Addresses
Primary practice location
1058 S Vermont Ave
Suite 109
Los Angeles, CA 90006-2721
Mailing address
1058 S Vermont Ave
Suite 109
Los Angeles, CA 90006-2721
Phone (213) 368-6300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7708 | Other | CA | HEARING AID DISPENSER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328140800000",
"number": "1396015152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1058 S VERMONT AVE",
"address_2": "SUITE 109",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900062721",
"telephone_number": "213-368-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1058 S VERMONT AVE",
"address_2": "SUITE 109",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900062721",
"telephone_number": "213-368-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JOHNNY",
"name_prefix": "Mr.",
"credential": "HAD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-10",
"last_updated": "2012-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "CA",
"license": "7708",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEARING AID DISPENSER",
"identifier": "7708",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.