Richard Park M.D., a Professional Corporation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

RICHARD PARK M.D., A PROFESSIONAL CORPORATION

Practice address

10515 Balboa Blvd Ste 325
Granada Hills, CA 91344-6364

Phone

(818) 678-9875

Fax

(747) 200-2589

NPI assigned

Mar 25, 2013

Organization subpart

No

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

Authorized official

Name

Richard Park, M.D.NPI 1174718134

Title

Ceo/Physician

Phone

(818) 678-9875

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Park, M.D.

  • Internal Medicine Physician
  • Granada Hills, CA
  • NPI 1174718134
  Medicare reassignment NPD Authorized official
• Philip Kim, MD

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1356781132
  NPD (past)

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1982946323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 ROCKY POINT CT",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913624943",
            "telephone_number": "805-368-1293",
            "fax_number": "888-981-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10515 BALBOA BLVD STE 325",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446364",
            "telephone_number": "818-678-9875",
            "fax_number": "747-200-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD PARK M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-25",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO/PHYSICIAN",
        "authorized_official_telephone_number": "818-678-9875",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Margarita Reyes, LCSW
• Rocky Velasquez Reyes
• Victoria Reynosa, PTA
• Joy M Riad
• Richard Niemeyer, MD, Inc.
• Richard Park, MD a Professional Corporation
• Rinaldi Care Home
• Rinaldi Operating Company LLC
• Manuel Antonio Rios
• Melissa Rios, PSYD

• Multi-Specialty Clinic/Center in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.