Elvin Park, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11908 Issued in CA

Legal business name

ELVIN PARK, NP

Practice address

1534 N Moorpark Rd # 327
Thousand Oaks, CA 91360-5129

Phone

(805) 701-1437

NPI assigned

Mar 20, 2008

Last updated

Apr 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Elvin Park, NP

Title

Ceo

Phone

(805) 701-1437

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1699946434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 N MOORPARK RD # 327",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 N MOORPARK RD # 327",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605129",
            "telephone_number": "805-701-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELVIN PARK, NP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ELVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-701-1437",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "11908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "WNP11908B",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; 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.