Sonny Park PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD18585 Issued in OR

Legal business name

SONNY PARK PC

Practice address

2120 Exchange St
Ste 200
Astoria, OR 97103-3365

Phone

(503) 325-5360

Fax

(503) 325-9373

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sangkun (Sonny) Park, MD

Title

Owner

Phone

(503) 325-5360

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Columbia Pacific Medical Services Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/7d7f9694-46c9-4670-abeb-9400514e3b75/

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sangkun Park, MD

  • Internal Medicine Physician
  • Astoria, OR
  • NPI 1477622991
  Medicare reassignment NPD

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1801919980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 EXCHANGE ST",
            "address_2": "STE 200",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033365",
            "telephone_number": "503-325-5360",
            "fax_number": "503-325-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 EXCHANGE ST",
            "address_2": "STE 200",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033365",
            "telephone_number": "503-325-5360",
            "fax_number": "503-325-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONNY PARK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SANGKUN (SONNY)",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-325-5360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD18585",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286976",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE GROUP NUMBER",
            "identifier": "091424000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Pacific Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria A Smith
• Allison Amber Snyder, M.D.
• Soberenity
• Jessica Soleil
• Candis Kay Sollars, LCSW
• Jennifer Nicole Sopko, PA-C
• Margaret A. Soukup
• Speech, Language and Learning Center of Astoria, LLC
• Jonathan R Sprague
• Jenna Rose Spurling, COTA

• Internal Medicine Physician in Astoria, OR
• Providers in Astoria, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.