Jae Man Park, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A105181 Issued in CA

Practice address

9535 Garden Grove Blvd
Suite 103
Garden Grove, CA 92844-1550

Phone

(714) 534-1112

Fax

(714) 534-1116

NPI assigned

Aug 14, 2008

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

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

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethel Medical Group IncGroup PAC ID 2163645300, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Bethel Medical Group, Inc.

  • Family Medicine Physician
  • Garden Grove, CA
  • NPI 1518388917
  Medicare reassignment Care Compare group
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1669628228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9535 GARDEN GROVE BLVD",
            "address_2": "SUITE 103",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441550",
            "telephone_number": "714-534-1112",
            "fax_number": "714-534-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9535 GARDEN GROVE BLVD",
            "address_2": "SUITE 103",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441550",
            "telephone_number": "714-534-1112",
            "fax_number": "714-534-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAE MAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A105181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saadia Parekh, PA-C
• Rebecca Park-Hem
• Esther Park
• Gunhwa Park, L AC
• Hyo Jae Elihu Park
• Jihae Park
• Jin Won Park, LAC
• Jinyoung Park, HOUSING SPECIALIST
• Jiwon Park
• Joanne Eunjin Park

• Internal Medicine Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.