Jason Chan Hyung Park, PT, DPT, SCS

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

42232 Issued in CA

Practice address

2440 W Carson St
Torrance, CA 90501-3146

Phone

(310) 701-9971

NPI assigned

Jun 13, 2018

Sex

Male

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

State licenses

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1629561667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 VENICE BLVD APT 207",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902915925",
            "telephone_number": "310-701-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905013146",
            "telephone_number": "310-701-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JASON",
        "middle_name": "CHAN HYUNG",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, SCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "42232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawnelle Park, DDS
• Enoch Joon Park
• Ezekiel Park
• Flora Park
• Hayoung Park
• Jeffrey Park
• Jiyoung Park, PHARMD
• Jonathan Keon Park
• Jong Hyuk Park
• Julie M Park, DDS

• Sports Physical Therapist in Torrance, CA
• Providers in Torrance, CA by specialty
• Sports Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.