Daniel Park

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A13220 Issued in CA

Practice address

13193 Central Ave
Chino, CA 91710-4179

Phone

(909) 464-9675

NPI assigned

Apr 20, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vast Home Health, Inc Home health agency, Burbank, CA, CCN 559036
• Providence at Home With Compassus Hospice Care Orange County Hospice, Anaheim, CA, CCN 051659
• Providence at Home With Compassus Hospice Care Orange County South Hospice, Mission Viejo, CA, CCN 551658
• Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
• The Pavilion at Sunny Hills Nursing home, Fullerton, CA, CCN 555733
• Park Regency Care Center Nursing home, La Habra, CA, CCN 555536
• Greenfield Care Center of Fullerton, LLC Nursing home, Fullerton, CA, CCN 056151
• St. Catherine Healthcare Nursing home, Fullerton, CA, CCN 055689

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpark1373065@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Foundation

  • Hematology & Oncology Physician
  • Orange, CA
  • NPI 1801443510
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fullerton Healthcare & Wellness Centre, LP

  • Skilled Nursing Facility
  • Fullerton, CA
  • NPI 1073944450

  Nursing home

  Care Compare affiliation
• Greenfield Care Center of Fullerton, LLC

  • Skilled Nursing Facility
  • Fullerton, CA
  • NPI 1871580480

  Nursing home

  Care Compare affiliation
• Park Regency Care LLC

  • Skilled Nursing Facility
  • La Habra, CA
  • NPI 1184720005

  Nursing home

  Care Compare affiliation
• Santa Catalina Healthcare, Inc.

  • Skilled Nursing Facility
  • Fullerton, CA
  • NPI 1205445848

  Nursing home

  Care Compare affiliation
• St Joseph Health System Home Care Services LLC

  • Community Based Hospice Care Agency
  • Irvine, CA
  • NPI 1578840260
  Care Compare affiliation
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  Care Compare affiliation
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Brea, CA
  • NPI 1891904942
  Care Compare affiliation
• St. Joseph Health System Home Care Services LLC

  • Home Health Agency
  • Anaheim, CA
  • NPI 1083697833

  Hospice

  Care Compare affiliation
• Vast Home Health, Inc

  • Home Health Agency
  • Van Nuys, CA
  • NPI 1487168449
  Care Compare affiliation

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

{
    "created_epoch": "1397952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1609296433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104179",
            "telephone_number": "909-464-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104179",
            "telephone_number": "909-464-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-20",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A13220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpark1373065@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "101 E Valencia Mesa Dr",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gladys Maria Paharik, FNP-C
• Wendy Paiva, PA-C
• Paloma Hospice Inc.
• Pamela J Harford, D.O., a Medical Corporation
• Panmed Anesthesia Services Inc
• Jakyung Park
• Miguel Park, DC.
• Tammy Park, PHARM D,RPH
• Atara Michelle Parkinson, LMFT
• Monish Parmar, MD

• Family Medicine Physician in Chino, CA
• Providers in Chino, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.