Active NPI
Michael Sehyun Park
- Pharmacist
- Ontario, CA
National Provider Identifier
1902393390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73131
- Practice address
- 2920 Inland Empire Blvd Ste 112
Ontario, CA 91764-6581 - Phone
- (909) 291-3800
- NPI assigned
- Apr 20, 2018
- Last updated
- Apr 20, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 73131 | CA | Primary |
Addresses
Primary practice location
2920 Inland Empire Blvd Ste 112
Ontario, CA 91764-6581
Mailing address
20626 Crestline Dr
Diamond Bar, CA 91765-4710
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 |
|---|---|---|---|
| 73131 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JMC Pharmacy, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524182400000",
"number": "1902393390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20626 CRESTLINE DR",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917654710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 INLAND EMPIRE BLVD STE 112",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917646581",
"telephone_number": "909-291-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "MICHAEL",
"middle_name": "SEHYUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-20",
"last_updated": "2018-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "73131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.