Active NPI
Minju Park
- Pharmacist
- Morgan Hill, CA
National Provider Identifier
1659866507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 78472
- Practice address
- 745 E Dunne Ave
Morgan Hill, CA 95037-4601 - Phone
- (408) 782-9591
- NPI assigned
- Jun 23, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH030192 | GA | |
| Pharmacist | 183500000X | 78472 | CA | Primary |
Addresses
Primary practice location
745 E Dunne Ave
Morgan Hill, CA 95037-4601
Mailing address
946 Heather Cir Apt 41W
Salinas, CA 93906-3949
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
| License | State | Type | Specialty |
|---|---|---|---|
| 78472 | CA | MD | Pharmacist |
| RPH030192 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
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": "1529712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1659866507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "946 HEATHER CIR APT 41W",
"city": "SALINAS",
"state": "CA",
"postal_code": "939063949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 E DUNNE AVE",
"city": "MORGAN HILL",
"state": "CA",
"postal_code": "950374601",
"telephone_number": "408-782-9591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "MINJU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-23",
"last_updated": "2021-10-27",
"certification_date": "2021-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH030192",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "78472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgan Hill, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.