Susan Lee Park, NP, L AC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95035073 Issued in CA

Practice address

2700 Alton Pkwy Ste 233
Irvine, CA 92606-2646

Phone

(949) 475-2500

NPI assigned

Jun 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1457511123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19745 E COLIMA RD",
            "address_2": "SUITE 12",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "91748",
            "telephone_number": "909-595-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 ALTON PKWY STE 233",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062646",
            "telephone_number": "949-475-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUSAN",
        "middle_name": "LEE",
        "credential": "NP, L AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "CA10252",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95035073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moonjoo Park
• Sarah Park
• SE J Park, NP-C, DNP
• So Y Park, L.AC.
• Sunmin Park
• Susie Park, OTR/L
• Tony J Park, PHARM.D., J.D.
• Unice Park
• Victor S Park
• Wonsang Park

• Gerontology Nurse Practitioner in Irvine, CA
• Providers in Irvine, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.