Chang-Gyu Park, DC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC7022 Issued in CA

Practice address

18361 Bear Valley Rd
Suite 6
Hesperia, CA 92345

Phone

(760) 948-0353

Fax

(760) 948-0354

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Kenneth Park Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1861595951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18361 BEAR VALLEY RD",
            "address_2": "SUITE 6",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "92345",
            "telephone_number": "760-948-0353",
            "fax_number": "760-948-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18361 BEAR VALLEY RD",
            "address_2": "SUITE 6",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "92345",
            "telephone_number": "760-948-0353",
            "fax_number": "760-948-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHANG-GYU",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25780",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC7022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNETH",
            "last_name": "PARK",
            "prefix": "MR.",
            "credential": "DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ruben Sergio Padilla
• Cassandra Adasue Paez
• Edward Allen Palmer
• Crystal Palomera
• Flo Pantozzi, MSW
• James Park
• Marinel Abellada Park, DNP,PMHNP
• Bianca Erin Parra Okhuysen, RDHAP
• Michael Anthony Parrish, DPT
• Nahian Parvez

• Acupuncturist in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.