Individual provider Active NPI

William Howard Park, O.D.

  • Optometrist
  • Temecula, CA
National Provider Identifier
1558487462
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13082T Issued in CA
Practice address
47001 Pala Rd
Temecula, CA 92592-2925
Phone
(951) 676-6810
Fax
(951) 225-6873
NPI assigned
Mar 22, 2007
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13082T CA Primary

Addresses

Primary practice location

47001 Pala Rd
Temecula, CA 92592-2925

Mailing address

47001 Pala Rd
Temecula, CA 92592-2925
Phone (951) 676-6810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160815000089 TX Practitioner - Optometry 9335042324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097

12784 Pechanga Rd
Perchanga Indian Health Clinic
Temecula, CA 92390-2987
Phone (951) 676-6810

47001 Pala Rd
Temecula, CA 92592-2925
Phone (951) 676-6810

48360 Pechanga Rd
Temecula, CA 92592-2986
Phone (951) 676-6810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13082CAMDProfessional Counselor
13082TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Jul 20, 2016 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Jul 20, 2016 Accepting new patients

Locations

11555 Potrero Rd
Banning, CA 92220
Phone (800) 732-8805

11555 Potrero Rd
#1-2
Banning, CA 92220
Phone (909) 849-4761

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

12784 Pechanga Rd
Temecula, CA 92592
Phone (678) 591-9108

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1558487462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47001 PALA RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925922925",
            "telephone_number": "951-676-6810",
            "fax_number": "951-225-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47001 PALA RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925922925",
            "telephone_number": "951-676-6810",
            "fax_number": "951-225-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "WILLIAM",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13082T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.