Active NPI
Erin Y Park, D.P.M.
- Podiatrist
- West Covina, CA
National Provider Identifier
1508977711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E4088
- Practice address
- 2707 E Valley Blvd Ste 303
West Covina, CA 91792-3198 - Phone
- (626) 330-4866
- Fax
- (626) 330-7989
- NPI assigned
- Aug 31, 2006
- Last updated
- Jan 15, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E4088 | CA | Primary |
Addresses
Primary practice location
2707 E Valley Blvd Ste 303
West Covina, CA 91792-3198
Mailing address
PO Box 5036
Diamond Bar, CA 91765-7036
Phone (626) 330-4866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E40882 | Medicaid | CA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050427000696 | CA | Practitioner - Podiatry | 6103865399 | Practice locations: West Covina, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- California School of Podiatric Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2707 E Valley Blvd
Suite 303
West Covina, CA 91792-3198
Phone (626) 330-4866
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 110 |
| Removal or shaving of skin growth | 49 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4088 | CA | MD | Audiologist |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- erin.park.p1@direct.caremorewest.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1508977711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5036",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917657036",
"telephone_number": "626-330-4866",
"fax_number": "626-330-7989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2707 E VALLEY BLVD STE 303",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917923198",
"telephone_number": "626-330-4866",
"fax_number": "626-330-7989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "ERIN",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E4088",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000E40882",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.