Su Jin Park

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

16864 Issued in CA

Practice address

6935 Tiger Horse Cir
Eastvale, CA 92880-3959

Phone

(213) 268-8161

NPI assigned

Jun 9, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1609225614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6935 TIGER HORSE CIR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803959",
            "telephone_number": "213-268-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6935 TIGER HORSE CIR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803959",
            "telephone_number": "213-268-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SU JIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andre Rafallo Padua, COTA/L
• Karen Palaganas, PHARMACIST
• Ivan Pamintuan
• Melica Panahi-Pour
• Parampara Inc.
• Avni Patel, M. ED
• Divyeshkumar R Patel, PHARMACIST RPH
• Keyurkumar Patel
• Mukesh Patel, PHARM D
• Shina Patel, P.A.

• Acupuncturist in Eastvale, CA
• Providers in Eastvale, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.