Douglas Park

Primary specialty

PharmacistTaxonomy code 183500000X

License

36088 Issued in CA

Practice address

13303 South St
Cerritos, CA 90703-7308

Phone

(562) 865-0612

NPI assigned

Dec 24, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Garfield Beach CVS LLC

  • Pharmacy
  • Lakewood, CA
  • NPI 1033153382
  NPD (past)
• Garfield Beach CVS, L.L.C.

  • Pharmacy
  • Jurupa Valley, CA
  • NPI 1780573113
  NPD (past)

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

{
    "created_epoch": "1608768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1750978722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13303 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037308",
            "telephone_number": "562-865-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13303 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037308",
            "telephone_number": "562-865-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DOUGLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-24",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "36088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhairavi D Parekh, DDS
• Brian Junyoung Park, PHARMD
• Chong Hoon Park
• David Park, AP
• Denise Park, MD
• Hyo Park, AC
• Jennifer Yoon Gaahee Park, PA-C
• John Bansuk Park, PHARM.D.
• June Park
• Juntae Park, LA.C

• Pharmacist in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.