PETER SANG-WOOK PARK


Address: 1501 W Commonwealth Ave, Fullerton, CA 92833-2727
Phone: 7144103100

PETER SANG-WOOK PARK (NPI# 1104825033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104825033
Entity Type Individual
Full Name PETER SANG-WOOK PARK
Credential DPM
Practice Address 1501 W Commonwealth Ave
Fullerton
CA 92833-2727
Mailing Address 1417 Stein Strauss St
Fullerton
CA 92833-2159
Practice Telephone 7144103100
Mailing Telephone 7147973668
Enumeration Date 2005-07-21
Last Update Date 2020-09-29
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 213E00000X Podiatrist E4031 CA Podiatric Medicine & Surgery Service Providers
Y 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
E4031 CA Podiatric Medicine & Surgery Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA NPI 1104825033 01
CA MEDICARE PTAN CE813A 01
CA MEDI CAL 00E40310 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
3130 W Olympic Blvd Ste 170, Los Angeles, CA 900062648 3237327551

Other Providers PETER PARK

NPI Name Taxonomy Address Enumeration
1033685177 Peter Sungil Park Obstetrics & Gynecology 31874 Summer Grape Ct, Winchester, CA 92596-8633 2018-10-16
1699015792 Peter Ju Park Radiology 100 Woodruff Cir Ne, Suite 327, Atlanta, GA 30322-0001 2013-02-26
1831296185 Peter Joonsun Park Emergency Medicine 34800 Bob Wilson Dr. Naval Medical Center, Department of Emergency Medicine, San Diego, CA 92134-1110 2006-09-20
1508899915 Peter C Park Family Medicine 30 Vt Route 100 S, Wilmington, VT 05363-7944 2006-07-09
1952359887 Peter K Park Physical Medicine & Rehabilitation 6447 E Riverside Blvd, Suite 102, Rockford, IL 61114-4421 2006-05-04
1154937241 Peter S Park Student in an Organized Health Care Education/Training Program 820 Memorial St Ste 1, Prosser, WA 99350-2504 2020-09-23
1437762275 Peter Park Pharmacist 1713 W Springfield Ave, Champaign, IL 61821-3011 2020-08-30
1831650043 Peter K Park Student in an Organized Health Care Education/Training Program 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 2019-03-29
1508392176 Peter Park Social Worker 4320 Diplomacy Dr, Anchorage, AK 99508-5925 2017-05-02
1043672892 Peter Yong Soo Park Internal Medicine 6431 Fannin St, Msb 2.116, Houston, TX 77030-1501 2016-03-22

Office Location

Street Address 1501 W COMMONWEALTH AVE
City FULLERTON
State CA
Zip Code 92833-2727

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811177256 Jessica M Rodriguez Nurse Practitioner 1501 W Commonwealth Ave, Fullerton, CA 92833-2727 2007-11-13
1609055300 Nancy Jeong-sun Han Internal Medicine 1501 W Commonwealth Ave, Fullerton, CA 92833-2727 2007-10-30
1205962842 Christina Elisabeth Phillips Physician Assistant 1501 W Commonwealth Ave, Fullerton, CA 92833-2727 2007-02-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790333565 Qz Enterpprises Corp In Home Supportive Care 2817 Muir Trail Dr, Fullerton, CA 92833 2019-08-26
1780114306 Acupuncture Nara Inc Clinic/Center 2334 W. Valencia Dr., Fullerton, CA 92833 2017-06-15
1518350149 Young A Lee Nurse Practitioner 2529 Monterey Pl, Fullerton, CA 92833 2015-03-06
1538557871 Annacess Arcadio Occupational Therapy Assistant 1437 W Woodcrest Ave, Fullerton, CA 92833 2015-01-08
1710306923 Nora Edith Heredia Counselor 1060 S Brookhurst Road, Fullerton, CA 92833 2014-04-15
1912322892 Louis Michael Hinzo Counselor 1060 S. Brookhurst Rd., Fullerton, CA 92833 2014-02-28
1497011290 Paul Choong Hwan Lee, M.d. A Medical Corporation Ophthalmology 1401 S. Brookhurst Rd., Suite 107, Fullerton, CA 92833 2012-04-05
1992073860 Tammy Phan Pharmacist 1826 W Orangethrope Ave, Fullerton, CA 92833 2011-12-07
1346577160 Hara Orthotics and Prosthetics,inc Prosthetic/Orthotic Supplier 1343 W. Valencia Dr., Suite E, Fullerton, CA 92833 2009-11-16
1265669923 Marcelle Bonneau Taylor Marriage & Family Therapist 1145 W. Valencia Mesa, Emmanuel Episcopal Church, Fullerton, CA 92833 2009-06-19
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Taxonomy Information

Taxonomy Code 213ES0103X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Foot & Ankle Surgery

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639102833 Orange County Foot and Ankle Group, Inc. Podiatrist 300 N Euclid St, Suite A, Fullerton, CA 92832-1623 2006-07-09
1144211889 Dale M Rosenblum Podiatrist 704 N Harbor Blvd, Fullerton, CA 92832-1520 2005-11-02
1881187755 Eric Naasz, Dpm Inc Podiatrist 704 N Harbor Blvd, Fullerton, CA 92832-1520 2018-06-14
1891949426 Corey M Lejeune Podiatrist 300 N Euclid St, Suite A, Fullerton, CA 92832-1623 2008-11-10
1083870315 Dale M. Rosenblum, Dpm Inc Podiatrist 704 N Harbor Blvd, Fullerton, CA 92832-1520 2008-08-06
1053571828 Lisbeth Marie Keplinger Podiatrist 2141 N Harbor Blvd, Suite 35000, Fullerton, CA 92835-3827 2008-06-14
1336237015 Stephanie J Nanson Podiatrist 300 N Euclid St, Suite A, Fullerton, CA 92832-1623 2006-10-10
1497850325 Jonathan Ian Bennett Podiatrist 300 N Euclid St, Suite A, Fullerton, CA 92832-1623 2006-09-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1114528726 Millennium Foot and Ankle Institute PC Podiatrist 26235 Ravenhill Rd, Santa Clarita, CA 91387-4046 2020-11-02
1861008054 Ronald J Belczyk, Dpm Inc. Podiatrist 5471 La Palma Ave Ste 106, La Palma, CA 90623-1792 2020-09-22
1174139356 Ronald J Belczyk, Dpm Inc. Podiatrist 4911 Van Nuys Blvd Ste 100, Sherman Oaks, CA 91403-1746 2020-09-22
1093327231 Upperline Healthcare California PC Podiatrist 2131 San Joaquin Hills Rd, Newport Beach, CA 92660-6507 2020-08-19
1841815545 Kenny Au Quach Podiatrist 17100 Euclid St # 4004, Fountain Valley, CA 92708-4004 2020-06-09
1417579129 Central California Leg, Foot, and Ankle Center, Inc. Podiatrist 11325 Park Square Dr Apt D204, Bakersfield, CA 93311-8854 2020-05-15
1487282109 Laura Y Lee, Dpm Inc Podiatrist 5525 Forestwood Dr, Sacramento, CA 95842-2128 2020-03-29
1780211458 Dupontdpm Inc. Podiatrist 651 1st St W Ste C, Sonoma, CA 95476-7046 2020-03-24
1659903722 Bay Area Foot Care, Inc Podiatrist 5924 Stoneridge Dr Ste 102, Pleasanton, CA 94588-2750 2020-02-06
1780215210 Albert Elhiani Dpm Inc Podiatrist 9340 W Pico Blvd Ste 2, Los Angeles, CA 90035-1255 2020-02-03
Find all providers with the same taxonomy

Competitor

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City FULLERTON
Zip Code 92833

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Dataset Information

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.

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