Lydia Somi Park, M.D., P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LYDIA SOMI PARK, M.D., P.C.

Practice address

402 W Broadway FL 21
San Diego, CA 92101-8574

Phone

(877) 222-4090

NPI assigned

Mar 31, 2022

Organization subpart

No

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

Authorized official

Name

Lydia Somi Park, MD

Title

Ceo

Phone

(877) 222-4090

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1760122261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W BROADWAY FL 21",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921018574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W BROADWAY FL 21",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921018574",
            "telephone_number": "877-222-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYDIA SOMI PARK, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_middle_name": "SOMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-222-4090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wil Kirk Lybarger, RAS, NCAC1
• Bethany Joy Lyche, M.D.
• Xander Lyday
• Mishaun Lyde, MSW
• Katherine P Lydecker, PHD
• Jessica Blair Lydiard, M.D.
• Tiffany Lydy, CA HAD
• Matthew Alan Lyes, MD
• Willis Hughes Lyford, M.D.
• Dane Lykins

• Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.