Individual provider Active NPI

Hyunkyo Park, M.D

  • Obstetrics & Gynecology Physician
  • San Jose, CA
National Provider Identifier
1699869743
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A36837 Issued in CA
Practice address
100 Oconnor Dr Ste 28
San Jose, CA 95128-1655
Phone
(408) 260-3900
Fax
(408) 260-3903
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A36837 CA Primary

Addresses

Primary practice location

100 Oconnor Dr Ste 28
San Jose, CA 95128-1655

Mailing address

100 Oconnor Dr Ste 28
San Jose, CA 95128-1655
Phone (408) 260-3900

Other practice location 1

2405 Forest Ave
#202
San Jose, CA 95128
Phone (408) 260-3900

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)
Enrolled
Credentials
Doctor of Medicine

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: hpark125928@santaclaravalley.direct-ci.net

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1699869743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OCONNOR DR STE 28",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281655",
            "telephone_number": "408-260-3900",
            "fax_number": "408-260-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OCONNOR DR STE 28",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281655",
            "telephone_number": "408-260-3900",
            "fax_number": "408-260-3903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2405 Forest Ave",
            "address_2": "#202",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "95128",
            "country_code": "US",
            "telephone_number": "408-260-3900",
            "fax_number": "408-260-3903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYUNKYO",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A36837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.