Individual provider Active NPI

Jun Hong Park, PROGRAM COORDINATOR

  • Rehabilitation Practitioner
  • Los Angeles, CA
National Provider Identifier
1922578962
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone
(213) 483-3000
NPI assigned
Dec 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Day Training/Habilitation Specialist 373H00000X CA
Rehabilitation Practitioner 225400000X Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

1310 Wilshire Blvd
Los Angeles, CA 90017-1705

Mailing address

1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone (213) 483-3000

Other practice location 1

600 St Paul Ave Ste 101
Los Angeles, CA 90017-5660
Phone (213) 483-3000

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

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1922578962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171705",
            "telephone_number": "213-483-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171705",
            "telephone_number": "213-483-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 St Paul Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900175660",
            "country_code": "US",
            "telephone_number": "213-483-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUN",
        "middle_name": "HONG",
        "credential": "PROGRAM COORDINATOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-03",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.