Active NPI
Mizin Park Kawasaki, M.D.
- Pediatrics Physician
- Thousand Oaks, CA
National Provider Identifier
1770747305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G063471
- Practice address
- 425 Haaland Dr
Suite 104
Thousand Oaks, CA 91361-5229 - Phone
- (805) 494-1948
- Fax
- (805) 494-1947
- NPI assigned
- Jul 13, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G063471 | CA | Primary |
Addresses
Primary practice location
425 Haaland Dr
Suite 104
Thousand Oaks, CA 91361-5229
Mailing address
24422 Avenida de la Carlota Ste 300
Laguna Hills, CA 92653-3628
Phone (949) 599-2434
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G063471 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Kids, a Professional Medical Corporation | Pediatrics | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Newport Beach, CA
- NPI 1740311737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653523200000",
"number": "1770747305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24422 AVENIDA DE LA CARLOTA STE 300",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926533628",
"telephone_number": "949-599-2434",
"fax_number": "499-599-2430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 HAALAND DR",
"address_2": "SUITE 104",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913615229",
"telephone_number": "805-494-1948",
"fax_number": "805-494-1947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAWASAKI",
"first_name": "MIZIN",
"middle_name": "PARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-13",
"last_updated": "2022-05-26",
"certification_date": "2022-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G063471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.