Individual provider Active NPI

Henry Yong Park

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1568338259
Registry record updated Oct 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
308996 Issued in CA
Practice address
1640 17TH St
San Francisco, CA 94107-2332
Phone
(415) 508-5658
NPI assigned
Oct 11, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 308996 CA Primary

Addresses

Primary practice location

1640 17TH St
San Francisco, CA 94107-2332

Mailing address

1640 17TH St
San Francisco, CA 94107-2332
Phone (415) 508-5658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
308996CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Desk Unrest Physical Therapy Inc Physical Therapist CurrentSince Oct 12, 2025 Accepting new patients

Locations

1640 17th St
San Francisco, CA 94107
Phone (415) 508-5658

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1760140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760140800000",
    "number": "1568338259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 17TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941072332",
            "telephone_number": "415-508-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 17TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941072332",
            "telephone_number": "415-508-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HENRY",
        "middle_name": "YONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-11",
        "last_updated": "2025-10-11",
        "certification_date": "2025-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "308996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2025; 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.