Agatha L Park, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

95-4263002 Issued in CA

Practice address

245 S Crescent Dr
Beverly Hills, CA 90212-4001

Phone

(310) 550-7669

Fax

(310) 247-0950

NPI assigned

Mar 9, 2007

Last updated

Mar 23, 2011By the provider in NPPES

Sex

Female

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1407988165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S CRESCENT DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124001",
            "telephone_number": "310-550-7669",
            "fax_number": "310-247-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S CRESCENT DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124001",
            "telephone_number": "310-550-7669",
            "fax_number": "310-247-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "AGATHA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "95-4263002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahil Parag, DO
• Samantha Paragona
• Giselle M Paredes, COTA
• Saghi Parham, D.D.S.
• Paris Surgical Center
• Alexandrea Park, PSY.D.
• Ann Park
• Aric Kihyun Park, M.D.
• Dorothy J. Park, M.D.
• Ji Won Park, PHARMD

• Specialist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; 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.