Robert Park M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

G22984 Issued in CA

Legal business name

ROBERT PARK M.D.

Practice address

191 Lynch Creek Way
Suite 205
Petaluma, CA 94954-2389

Phone

(707) 765-1501

Fax

(707) 765-1530

NPI assigned

Sep 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Park, M.D.

Title

Owner

Phone

(707) 765-1501

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Barbara Finzen, M.D.

  • Internal Medicine Physician
  • Novato, CA
  • NPI 1134225352
  NPD (past)

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1538356035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 LYNCH CREEK WAY",
            "address_2": "SUITE 205",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542389",
            "telephone_number": "707-765-1501",
            "fax_number": "707-765-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 LYNCH CREEK WAY",
            "address_2": "SUITE 205",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542389",
            "telephone_number": "707-765-1501",
            "fax_number": "707-765-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT PARK M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-765-1501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G22984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miles Rivers
• Thomas Alan Robbe, MFT
• Autumn Roberge, MSCN, RD
• Robert I Ostroff MD Inc
• Robert O Butler
• Tyler James Robinson
• Elio A Robles
• Nelson Robles, MSW
• Hannah Rochelle
• Whitney Rodgers

• Nephrology Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.