Individual provider Active NPI

Jason Kieth Park, D.C.

  • Chiropractor
  • Sunnyvale, CA
National Provider Identifier
1407000599
Registry record updated Nov 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
31077 Issued in CA
Practice address
333 W El Camino Real
Suite 390
Sunnyvale, CA 94087-1973
Phone
(408) 733-7330
NPI assigned
Nov 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 31077 CA Primary

Addresses

Primary practice location

333 W El Camino Real
Suite 390
Sunnyvale, CA 94087-1973

Mailing address

1656 Yosemite Dr
Milpitas, CA 95035-6550

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1226793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226793600000",
    "number": "1407000599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 YOSEMITE DR",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950356550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W EL CAMINO REAL",
            "address_2": "SUITE 390",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940871973",
            "telephone_number": "408-733-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JASON",
        "middle_name": "KIETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-16",
        "last_updated": "2008-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2008; 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.