Sung Ho Park, D.O

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

20A7204 Issued in CA

Practice address

1415 Ross Ave
El Centro, CA 92243-4306

Phone

(951) 929-6260

Fax

(951) 765-2855

NPI assigned

Nov 27, 2006

Last updated

Feb 14, 2022By the provider in NPPES

Sex

Male

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1801962592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925460788",
            "telephone_number": "951-929-6260",
            "fax_number": "951-765-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ROSS AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434306",
            "telephone_number": "951-929-6260",
            "fax_number": "951-765-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUNG",
        "middle_name": "HO",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A7204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX72040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guadalupe Belen Paredes-Zambrano
• Walt E Parent, PHD
• Drupad Parikh, PHARMD
• Kyoung Jin Park
• Sangho Park, DDS
• George Nestor Parra
• Karla Berenice Parra
• Kristin Parrish
• Joanna Rosario Partida
• Angela Marie Pascua, NONE

• Anesthesiology Physician in El Centro, CA
• Providers in El Centro, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.