Stefanie Midori Park, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

14109 Issued in HI

Practice address

347 N Kuakini St
Honolulu, HI 96817-2336

Phone

(808) 536-2236

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1790804151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 KAIMUKI AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968161420",
            "telephone_number": "808-753-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 N KUAKINI ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172336",
            "telephone_number": "808-536-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "STEFANIE",
        "middle_name": "MIDORI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "14109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "594300",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Park
• Melanie Park, APRN
• Philip Duheung Park, DDS
• Sarah Y. Park, M.D.
• Sharon Park, MD
• Suzanne I. Park, LCSW
• Taryn Park, MD
• Thomas Park, MD
• Yank Sook Park, RN
• Young Cha Park, M.D.

• Internal Medicine Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Internal Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.