JOE PARK (NPI# 1083645832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083645832 |
| Entity Type | Individual |
| Full Name | JOE PARK |
| Credential | M.D. |
| Practice Address |
15447 W Sand St Victorville CA 92392-2904 |
| Practice Telephone | 7608439679 |
| Practice Fax Number | 7602453618 |
| Mailing Telephone | 7608439679 |
| Mailing Fax Number | 7602453618 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
A86588 | CA | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
A86588 | CA | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
A86588 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A865880 | 05 | |
| CA | DEA | BP8350100 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790734572 | Joe W Park | Chiropractor | 801 N Tustin Ave Ste 302, Santa Ana, CA 92705-3601 | 2006-05-09 |
| 1144457623 | Joe Young Park | Radiology | 1542 Tulane Ave, Rm 353, New Orleans, LA 70112-2865 | 2009-06-11 |
| 1174626436 | Joe Buck Park | Pharmacist | 515 Preston Royal Village, Dougherty's Pharmacy Inc., Dallas, TX 75230 | 2006-09-05 |
| Street Address |
15447 W SAND ST |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92392-2904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821186776 | Jp Anesthesiology, Inc | Anesthesiology | 15447 W Sand St, Victorville, CA 92392-2904 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215568688 | Kristin Parris | Behavior Technician | 15490 Civic Drive, Victorville, CA 92392 | 2020-02-03 |
| 1366001604 | Pine Ridge Treatment Centers, Inc. | Substance Abuse Rehabilitation Facility | 15367 Bonanza Rd, Ste A, Victorville, CA 92392 | 2019-06-11 |
| 1851871289 | Betty A. Murphy, Lmft, Inc | Marriage & Family Therapist | 15437 Anacapa Rd. Ste 26, Victorville, CA 92392 | 2018-08-15 |
| 1104313402 | Jorge L Soler Iglesias | Nurse Practitioner | 12459 Cricket St., Victorville, CA 92392 | 2018-04-23 |
| 1689192049 | Jamesina Johns | Nurse Practitioner | 12127 Mall Blvd #148, Victorville, CA 92392 | 2017-09-06 |
| 1285151886 | Jasmin Sanchez | Behavioral Analyst | 13201 Eclipse Ave, Victorville, CA 92392 | 2017-08-24 |
| 1174049829 | Virginia Marshall | Behavioral Analyst | 13901 Amargosa Rd., Victorville, CA 92392 | 2017-08-15 |
| 1346781465 | San Bernardino Conty | Counselor | 15480 Ramona Ave., Victoville, CA 92392 | 2017-03-09 |
| 1841741279 | Lorinda Morreale | Marriage & Family Therapist | 15428 Civic Dr. Ste 200, Act Family Counseling, Victorville, CA 92392 | 2016-10-20 |
| 1235582404 | Greater Hope Foundation | Community/Behavioral Health | 14344 Cajon Avenue, Suite 101, 103, Victorville, CA 92392 | 2016-07-22 |
| Find all providers in zip 92392 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275710964 | Navdeep Loomba Md Inc. | Anesthesiology | 15610 Bear Valley Rd Ste A, Victorville, CA 92395-8822 | 2008-01-25 |
| 1821186776 | Jp Anesthesiology, Inc | Anesthesiology | 15447 W Sand St, Victorville, CA 92392-2904 | 2006-10-10 |
| 1437240314 | Wendell Mark Street | Anesthesiology | 14075 Hesperia Rd, Suite 205, Victorville, CA 92395-4500 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912512567 | Clinicas Del Valle, Inc | Anesthesiology | 120 W. Cole Blvd, Ste. B, Calexico, CA 92231 | 2020-09-10 |
| 1609489418 | Cyrus Dadachanji Md Inc. | Anesthesiology | 34762 Midland Ave, Murrieta, CA 92563-8419 | 2020-08-31 |
| 1962050401 | Sky Anesthesia Inc. | Anesthesiology | 4477 W 118th St Ste 501, Hawthorne, CA 90250-2260 | 2019-08-28 |
| 1932671856 | North County Pain Institute | Anesthesiology | 940 E Valley Pkwy Ste K, Escondido, CA 92025-3441 | 2018-12-18 |
| 1285101824 | 16th Street Anesthesia Services Corp | Anesthesiology | 2323 16th St Ste 507, Bakersfield, CA 93301-3454 | 2018-11-01 |
| 1033697305 | Heyer Anesthesia PC | Anesthesiology | 1120 W La Veta Ave Ste 330, Orange, CA 92868-4231 | 2018-07-30 |
| 1982190229 | Algos Inc., A Medical Corporation | Anesthesiology | 12840 Riverside Dr Ste 208, Valley Village, CA 91607-3343 | 2018-07-10 |
| 1093200610 | Kevin Dinh Trinh, Md Inc. | Anesthesiology | 100 Fieldwood, Irvine, CA 92618 | 2018-06-26 |
| 1033616644 | Howard Siegel Md Inc | Anesthesiology | 8112 Milliken Ave Ste 202, Rancho Cucamonga, CA 91730-7473 | 2018-04-10 |
| 1780198952 | Unified Physician Associates Inc | Anesthesiology | 3200 S Bristol St Ste B, Santa Ana, CA 92704-6711 | 2017-11-27 |
| Find all providers with the same taxonomy | ||||
| City | VICTORVILLE |
| Zip Code | 92392 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.