Jennifer Yoon Gaahee Park, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA18765 Issued in CA

Practice address

11900 South St
Cerritos, CA 90703-6847

Phone

(888) 227-3312

NPI assigned

Dec 1, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Yoon Professional name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jennifer.park.1@3488.direct.athenahealth.com

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.

• Totalcare Walk in Clinic Inc

  • Internal Medicine Physician
  • Chino, CA
  • NPI 1760689715
  Medicare reassignment

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1558516708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 RAINBOW TERRACE LN",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906401951",
            "telephone_number": "323-566-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036847",
            "telephone_number": "888-227-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JENNIFER",
        "middle_name": "YOON GAAHEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONSUMER AFFAIRS-CA",
            "identifier": "PA18765",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jyoon1132120@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1538 E Chapman Ave",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928662231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jyoon1132120@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "11900 South St",
            "city": "Cerritos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907036847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "YOON",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chong Hoon Park
• David Park, AP
• Denise Park, MD
• Douglas Park
• Hyo Park, AC
• John Bansuk Park, PHARM.D.
• June Park
• Juntae Park, LA.C
• Sae Hee Park, N.P.
• Wonpyo Eric Park, D.D.S

• Medical Physician Assistant in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.