Young Il Park, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95023005 Issued in CA

Practice address

525 N Madison Ave Apt 103
Los Angeles, CA 90004-2285

Phone

(213) 308-0777

NPI assigned

Dec 19, 2022

Last updated

Dec 19, 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Community Health Centers IncGroup PAC ID 9638082456, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Community Health Centers Inc

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1356362743
  Medicare reassignment Care Compare group NPD
• Comprehensive Community Health Centers Inc

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1679553192
  NPD
• Comprehensive Community Health Centers, Inc

  • Family Medicine Physician
  • Arleta, CA
  • NPI 1346951654
  NPD

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1811609100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N MADISON AVE APT 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042285",
            "telephone_number": "213-308-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N MADISON AVE APT 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042285",
            "telephone_number": "213-308-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YOUNG",
        "middle_name": "IL",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023005",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95173940",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yong Hwan Park, D.C
• Yong S. Park, MD
• Yong Sue Park, PHD
• Yongeul Park, LAC
• Young H Park
• Young Jae Park, DC
• Youngsun Park, ACUPUNCTURE
• Yung J Park, RPH
• Yury Park, R.D.N.
• Yusol Anne Park

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.
• 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.