Active NPI
John Park, DC
- Chiropractor
- Tustin, CA
National Provider Identifier
1811265697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC32032
- Practice address
- 2600 Walnut Ave Ste F
Tustin, CA 92780-7032 - Phone
- (714) 730-1234
- NPI assigned
- Dec 7, 2011
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC32032 | CA | Primary |
Addresses
Primary practice location
2600 Walnut Ave Ste F
Tustin, CA 92780-7032
Mailing address
2600 Walnut Ave Ste F
Tustin, CA 92780-7032
Phone (714) 730-1234
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 |
|---|---|---|---|
| DC32032 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1811265697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 WALNUT AVE STE F",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927807032",
"telephone_number": "714-730-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 WALNUT AVE STE F",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927807032",
"telephone_number": "714-730-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-07",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC32032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.