Annie Park, MAOTRL

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

10975 Issued in CA

Practice address

2552 Kelvin Ave
Unit 302
Irvine, CA 92614-5851

Phone

(949) 233-8931

NPI assigned

Dec 4, 2012

Last updated

Dec 4, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1811232739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 KELVIN AVE",
            "address_2": "UNIT 302",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 KELVIN AVE",
            "address_2": "UNIT 302",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145851",
            "telephone_number": "949-233-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANNIE",
        "credential": "MAOTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "CA",
            "license": "10975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eunice Park
• Eunyung Park, DDS

• Gerontology Occupational Therapist in Irvine, CA
• Providers in Irvine, CA by specialty
• Gerontology Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.