NPIMap

Individual provider Active NPI

Jonathan Keon Park

  • Vascular & Interventional Radiology Physician
  • Torrance, CA
National Provider Identifier
1720215486
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A113114 Issued in CA
Practice address
3330 Lomita Blvd
Torrance, CA 90505-5002
Phone
(310) 325-9110
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X A113114 CA Primary

Addresses

Primary practice location

3330 Lomita Blvd
Torrance, CA 90505-5002

Mailing address

3330 Lomita Blvd
Torrance, CA 90505-5002
Phone (310) 325-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120510000404 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9830351790 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians
Torrance Radiology Medical GroupGroup PAC ID 5496764755, 19 clinicians
Torrance Memorial Medical CenterGroup PAC ID 9638087703, 52 clinicians

Practice addresses (Care Compare)

2110 E El Segundo Blvd
Suite 100
El Segundo, CA 90245-4502
Phone (310) 517-7010

3330 Lomita Blvd
Torrance, CA 90505-5002
Phone (310) 517-4675

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A113114CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Mar 22, 2017 Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Mar 22, 2017 Accepting new patients
Torrance Memorial Medical Center CurrentSince Feb 18, 2017 Accepting new patients
Torrance Radiology Medical Group Diagnostic Radiology CurrentSince Jul 29, 2018 Accepting new patients
County of Los Angeles Current Accepting new patients
Torrance Memorial Medical Center Diagnostic Radiology CurrentSince Feb 18, 2017 Accepting new patients
Torrance Health Association Inc CurrentSince Sep 1, 2022 Accepting new patients
The Regents of the University of California Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

2110 E El Segundo Blvd
Ste 100
El Segundo, CA 90245
Phone (310) 517-7010

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

3330 Lomita Blvd
Fl 5
Torrance, CA 90505
Phone (310) 517-4735

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

Organizations & group practices 9

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1720215486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 LOMITA BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055002",
            "telephone_number": "310-325-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 LOMITA BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055002",
            "telephone_number": "310-325-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JONATHAN",
        "middle_name": "KEON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A113114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.