Samuel Park, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

275 W Hospitality LN Ste 100
San Bernardino, CA 92408-3238

Phone

(909) 567-2221

Fax

(909) 763-3216

NPI assigned

Jun 29, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Transit Physical Therapy PC

  • Physical Therapy Clinic/Center
  • San Bernardino, CA
  • NPI 1417485889

  Physical Therapist

  NPD

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

{
    "created_epoch": "1782691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1861319196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 E COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928324903",
            "telephone_number": "909-567-2221",
            "fax_number": "909-763-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W HOSPITALITY LN STE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083238",
            "telephone_number": "909-567-2221",
            "fax_number": "909-763-3216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Barranca St Ste 920",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917911654",
            "country_code": "US",
            "telephone_number": "626-263-6469",
            "fax_number": "626-332-5298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SAMUEL",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Park
• David Park, PHARM D
• Elizabeth Anne Park, PSY.D.
• Julia Jungin Park, D.D.S.
• Kenneth Park
• Sola Park
• Yong Hoon Park, L.AC
• Alexis Kimani Parker, MS
• Jade Parker
• Jasmine Parker

• Physical Therapist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.