Christine Lim-Fun Chan Park, M.D., MPH

Individual provider Active NPI Pediatrics Physician · San Fernando, CA

NPI 1790786341 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1790786341
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
A74636 (CA)
Practice address
1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone
(818) 365-8086
Fax
(818) 898-4826
NPI assigned
Aug 4, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 15

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.

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Medicare Care Compare profile

Specialty
Pediatric Medicine
Education
University of California, Geffen School of Medicine, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Northeast Valley Health Corporation (77 clinicians)

Practice addresses (Care Compare)

12451 Gain St
Pacoima, CA 91331-1642
Phone (818) 897-2193

12540 Pierce St
Pacoima, CA 91331-1701
Phone (818) 897-2193

12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone (818) 896-0531

12759 Van Nuys Blvd
Pacoima, CA 91331-1627
Phone (818) 485-8250

1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 365-8086

7107 Remmet Ave
Canoga Park, CA 91303-2016
Phone (818) 340-3570

7843 Lankershim Blvd
North Hollywood, CA 91605-2523
Phone (818) 826-5555

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northeast Valley Health Corporation
Van Nuys, CA · CCN 051810
Federally qualified health center Corporate Officer Jul 27, 2003
Pacoima Health Center
Pacoima, CA · CCN 051899
Federally qualified health center Corporate Officer Jul 17, 2003
San Fernando Health Center
San Fernando, CA · CCN 051900
Federally qualified health center Corporate Officer Jul 17, 2003
Canoga Park Health Center
Canoga Park, CA · CCN 551845
Federally qualified health center Corporate Officer Jul 17, 2003
Sun Valley Health Center
Sun Valley, CA · CCN 051137
Federally qualified health center Corporate Officer Jul 17, 2003
Mobile Health Center
San Fernando, CA · CCN 921175
Federally qualified health center Corporate Officer Jul 17, 2003
Santa Clarita Health Center
Santa Clarita, CA · CCN 551074
Federally qualified health center Corporate Officer Jul 13, 2003
Pacoima Women'S Health Center
Pacoima, CA · CCN 921197
Federally qualified health center Corporate Officer Jul 17, 2003
Transitions to Wellness North Hollywood Health Center
North Hollywood, CA · CCN 921969
Federally qualified health center Corporate Officer Jul 17, 2003

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20041215000587 CA Practitioner - Pediatric Medicine 7315904919 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A74636CAMDPediatrics Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Northeast Valley Health Corporation Current
since Aug 21, 2016
Accepting new patients
Northeast Valley Health Corporation Current
since Aug 21, 2016
Accepting new patients
Northeast Valley Health Corporation Current Accepting new patients

Locations

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

12756 Van Nuys Blvd
Pacoima, CA 91331
Phone (818) 896-0531

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086

7223 Fair Ave
Sun Valley, CA 91352
Phone (818) 432-4400

23763 Valencia Blvd
Valencia, CA 91355
Phone (661) 287-1551

6551 Van Nuys Blvd
Ste 201
Van Nuys, CA 91401
Phone (818) 765-8656

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: christine.park.p1@direct.nevhc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A74636 CA Yes

Addresses

Primary practice location

1600 San Fernando Rd
San Fernando, CA 91340-3115

Mailing address

1172 N Maclay Ave
San Fernando, CA 91340-1328
Phone (818) 898-1388

Other names

  • Christine Lim-Fun Chan Former name

Other providers in San Fernando, CA

All providers in San Fernando, CA · Pediatrics Physician in California

Sources for this page

Verify at the official NPI Registry.