Edward H. Park MD., a Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

A75993 Issued in CA

Legal business name

EDWARD H. PARK MD., A MEDICAL CORPORATION

Practice address

1330 San Bernardino Rd Ste C
Upland, CA 91786-4980

Phone

(909) 981-8985

NPI assigned

Dec 9, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Autumn Szarzynski

Title

Office Manager

Phone

(909) 981-8985

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1730324443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 SAN BERNARDINO RD STE C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864980",
            "telephone_number": "909-981-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SAN BERNARDINO RD STE C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864980",
            "telephone_number": "909-981-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD H. PARK MD., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-09",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "SZARZYNSKI",
        "authorized_official_first_name": "AUTUMN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "909-981-8985",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A75993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Upland, CA
• Providers in Upland, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.