Jongsook Susie Park, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

C41515 Issued in CA

Practice address

12665 Garden Grove Blvd #505
Garden Grove, CA 92843

Phone

(714) 534-2110

Fax

(714) 534-1155

NPI assigned

Apr 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821052630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD #505",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92843",
            "telephone_number": "714-534-2110",
            "fax_number": "714-534-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD #505",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92843",
            "telephone_number": "714-534-2110",
            "fax_number": "714-534-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JONGSOOK",
        "middle_name": "SUSIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "C41515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C415150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jihae Park
• Jin Won Park, LAC
• Jinyoung Park, HOUSING SPECIALIST
• Jiwon Park
• Joanne Eunjin Park
• Joo Ae Park, AMFT, RN
• Joonkyu Park, D.C.
• Joseph Park, DPT
• Jun Gyu Park, DDS
• Kideog Park

• Gynecology Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.