Optimum Medical Clinics Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A050474 Issued in CA

Legal business name

OPTIMUM MEDICAL CLINICS INC

Practice address

20072 SW Birch St
Ste 100
Newport Beach, CA 92660-0794

Phone

(949) 757-1150

Fax

(949) 757-1170

NPI assigned

Oct 25, 2006

Organization subpart

No

Name

Dr. Samuel Kyung-Uk Park, MDNPI 1497832661

Title

Medical Director

Phone

(949) 757-1150

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Optimum Medical Clinics, Inc

  • Non-Pharmacy Dispensing Site
  • Newport Beach, CA
  • NPI 1043520885
  NPPES parent name

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel K. Park, M.D.

  • Family Medicine Physician
  • Newport Beach, CA
  • NPI 1497832661

  CA, Family Medicine

  Medicare reassignment NPD Authorized official
• Ryan Andrew Fan, MD

  • Orthopaedic Surgery Physician
  • Fountain Valley, CA
  • NPI 1720052459

  CA

  Medicare reassignment NPD
• Alejandro Lazaro Gonzalez

  • General Practice Physician
  • South Gate, CA
  • NPI 1538108097

  CA

  Medicare reassignment NPD
• Sahar E. Lashin, M.D.

  • Internal Medicine Physician
  • Lake Forest, CA
  • NPI 1598053894

  CA

  Medicare reassignment NPD
• Ellen Teresa Song, M.D.

  • Pediatrics Physician
  • Irvine, CA
  • NPI 1528079589

  CA

  Medicare reassignment NPD
• Parth Patel, PT

  • Physical Therapist
  • Newport Beach, CA
  • NPI 1194086595
  NPD

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Optimum Medical Clinics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Optimum Medical Clinics, Inc

  • Non-Pharmacy Dispensing Site
  • Newport Beach, CA
  • NPI 1043520885
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649354366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20072 SW BIRCH ST",
            "address_2": "STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600794",
            "telephone_number": "949-757-1150",
            "fax_number": "949-757-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20072 SW BIRCH ST",
            "address_2": "STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600794",
            "telephone_number": "949-757-1150",
            "fax_number": "949-757-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM MEDICAL CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "KYUNG-UK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "949-757-1150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A050474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Open Chapters Licensed Clinical Social Worker Corporation
• Operation Rooftop
• Amy P. Opfell, M.D.
• Optilife, Inc.
• Optimapath Inc
• Optimum Medical Clinics, Inc
• Senam E Oraha, MD
• Taurean Oram
• Orange Coast Cardiology Medical Corporation
• Orange Coast Oncology Hematology Medical Associates

• All providers in Newport Beach, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.