Park Optometry, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

10394T Issued in CA

Legal business name

PARK OPTOMETRY, INC

Practice address

1939 Grand Ave
San Diego, CA 92109-4508

Phone

(858) 272-2211

NPI assigned

Nov 22, 2005

Organization subpart

No

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

Authorized official

Name

David Park, O.D.NPI 1356324131

Title

Optometrist

Phone

(858) 272-2211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• David C Park, O.D.

  • Optometrist
  • San Diego, CA
  • NPI 1356324131
  Medicare reassignment Care Compare group NPD Authorized official
• Christy Chu-Park, O.D.

  • Optometrist
  • San Diego, CA
  • NPI 1144203332
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720061914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 GRAND AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 GRAND AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094508",
            "telephone_number": "858-272-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "858-272-2211",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10394T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Medical Pharmacy (Medical Center Pharmacy)
• Park Medical Pharmacy, Inc (Medical Center Pharmacy)
• Park Medical Physical Therapy, Prof Corp
• Park Medical Physical Therapy, Prof Corp
• Park Medical Supplies, Inc
• Park Row Podiatry Inc. (Nicholas N. DeSantis DPM)
• Aaron Park
• Aaron Park
• Alice Park
• Andrew C Park, DMD

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist 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.