Kyung Choon Park, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

35135 Issued in CA

Practice address

6000 Physicians Blvd
Bakersfield, CA 93301-5840

Phone

(661) 327-4499

NPI assigned

Oct 6, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clearview Optometry Corp

  • Clinic/Center
  • Shafter, CA
  • NPI 1386367936
  Medicare reassignment NPD Authorized official
• Golden State Eye Medical Group Inc

  • Ophthalmology Physician
  • Bakersfield, CA
  • NPI 1205847746

  Optometrist

  Medicare reassignment NPD
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD (past)

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1487316550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11205 STRATHAVEN ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933127016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 PHYSICIANS BLVD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933015840",
            "telephone_number": "661-327-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KYUNG CHOON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-06",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1114",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jieun Park
• Joanne J Park, RPH
• Jonathan Michael Park
• Kiefer Sungwhan Park, DDS
• Kyoung Hee Park
• Nathaniel Jeong Su Park
• Woori Park
• Yong Eon Park, DDS
• Young Wu Park, MD
• Amanda Brooke Parker Trautmann, LCW

• Optometrist in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.