Active NPI
Kilhong Park, M.D.
- Family Medicine Physician
- Bellevue, WA
National Provider Identifier
1952327215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 39915
- Practice address
- 14150 NE 20TH St Ste F1
#402
Bellevue, WA 98007-3700 - Phone
- (425) 454-6868
- Fax
- (425) 454-6869
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 39915 | WA | Primary |
Addresses
Primary practice location
14150 NE 20TH St Ste F1
#402
Bellevue, WA 98007-3700
Mailing address
14150 NE 20TH St F1
#402
Bellevue, WA 98007
Phone (425) 454-6868
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39915 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248307200000",
"number": "1952327215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14150 NE 20TH ST F1",
"address_2": "#402",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98007",
"telephone_number": "425-454-6868",
"fax_number": "425-454-6869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14150 NE 20TH ST STE F1",
"address_2": "#402",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980073700",
"telephone_number": "425-454-6868",
"fax_number": "425-454-6869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "KILHONG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2009-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "39915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.