Active NPI
Won Sun Park
- Pharmacist
- Redding, CA
National Provider Identifier
1801419171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 81535
- Practice address
- 317 Lake Blvd Ste B
Redding, CA 96003-2504 - Phone
- (530) 999-6099
- NPI assigned
- May 21, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 81535 | CA | Primary |
Addresses
Primary practice location
317 Lake Blvd Ste B
Redding, CA 96003-2504
Mailing address
1056 Burton Dr Apt B
Redding, CA 96003-5002
Phone (714) 745-9009
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81535 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590019200000",
"number": "1801419171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1056 BURTON DR APT B",
"city": "REDDING",
"state": "CA",
"postal_code": "960035002",
"telephone_number": "714-745-9009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 LAKE BLVD STE B",
"city": "REDDING",
"state": "CA",
"postal_code": "960032504",
"telephone_number": "530-999-6099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "WON SUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-21",
"last_updated": "2020-05-21",
"certification_date": "2020-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "81535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.