CHAN HO PARK (NPI# 1144828963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144828963 |
| Entity Type | Individual |
| Full Name | CHAN HO PARK |
| Credential | PA-C |
| Practice Address |
4721 Oakwood Ave Los Angeles CA 90004-3112 |
| Practice Telephone | 2066607988 |
| Mailing Telephone | 2066607988 |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508404492 | Chan Jin Park | Acupuncturist | 21537 48th Ave Apt 2b, Bayside, NY 11364-1359 | 2019-12-11 |
| 1700147378 | Chan H Park | Internal Medicine | 22226 Cliff Ave S, #304, Des Moines, WA 98198-4619 | 2012-05-30 |
| 1760644280 | Chan Woo Park | Otolaryngology | 90 Bergen Street- Suite 8100, Department of Otolaryngology, Doc Building, Newark, NJ 07103 | 2008-06-26 |
| 1700092103 | Chan Hoon Park | Family Medicine | 905 Victory Hwy, Slatersville, RI 02876 | 2007-05-15 |
| 1871617027 | Chan M Park | Dentist | 111 Deerwood Rd Ste 130, San Ramon, CA 94583-2194 | 2007-03-16 |
| 1457467037 | Chan M Park | Family Medicine | 6460 Greensboro Rd, Ridgeway, VA 24148-3478 | 2006-08-23 |
| 1619940681 | Chan S. Park | Emergency Medicine | Michumi, Pllc Dba Med Express of Williamsburg, Va, 120 Monticello Ave, Williamsburg, VA 23185 | 2006-02-09 |
| 1255336665 | Chan H. Park | Family Medicine | 9500 Stockdale Hwy, Suite 203, Bakersfield, CA 93311-3620 | 2005-06-14 |
| 1366071045 | Chan Young Park | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd Bldg 500, Los Angeles, CA 90073-1003 | 2020-04-05 |
| 1932498722 | Chan Jerome Park | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 600 Highland Ave, Madison, WI 53792-0001 | 2011-03-31 |
| Street Address |
4721 OAKWOOD AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90004-3112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225504160 | Jessica M. Louie | Pharmacist | 590 North Vermont Avenue, Suite 334, Los Angeles, CA 90004 | 2018-10-18 |
| 1033615828 | Javier G Ibarra | Counselor | 3910 Oakwood Ave., Los Angeles, CA 90004 | 2018-04-02 |
| 1558804351 | Bhc Alhamba Hospital | Psychiatric Residential Treatment Facility | 115 N. Mccadden Place, Los Angeles, CA 90004 | 2016-11-28 |
| 1275907719 | Rozalin Banafsheian | Psychologist | 522 N. Larchmont, Los Angeles, CA 90004 | 2015-11-20 |
| 1104214196 | Estrellita Rubio Reyes | Pediatrics | 3908 Beverly Blvd., Los Angeles, CA 90004 | 2014-12-30 |
| 1760888226 | Hardy Ophuls | Marriage & Family Therapist | 439 N. Larchmont Bl., Los Angeles, CA 90004 | 2014-11-11 |
| 1528462991 | Latrice Nicole Hardison | Licensed Vocational Nurse | 225 N. Mariposa Ave, Los Angeles, CA 90004 | 2014-10-14 |
| 1215331947 | Shonn Bunn | Rehabilitation Practitioner | 433 N. Hoover, Los Angeles, CA 90004 | 2014-10-09 |
| 1609296581 | Michael Armen Kezian | Dentist | 581 N Larchmont Blvd, Los Angeles, CA 90004 | 2014-04-18 |
| 1427485549 | Kir Medical Group | Family Medicine | 123 177th Street, Los Angeles, CA 90004 | 2013-10-03 |
| Find all providers in zip 90004 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929644 | Tatum Little | Physician Assistant | 3307 W 79th St, Los Angeles, CA 90043-5249 | 2020-10-15 |
| 1235737172 | Jennifer Rae Levitt Physician Assistant, Inc | Physician Assistant | 1439 N Highland Ave Ste 1059, Los Angeles, CA 90028-7622 | 2020-10-13 |
| 1174120943 | Melody Fatehi | Physician Assistant | 6228 Orange St Apt 9, Los Angeles, CA 90048-4836 | 2020-10-05 |
| 1467063826 | Hannah Shannon Rihani | Physician Assistant | 1737 Midvale Ave, Los Angeles, CA 90024-5512 | 2020-08-11 |
| 1356969901 | Emily Rachel Lavi | Physician Assistant | 1132 S Holt Ave Apt 7, Los Angeles, CA 90035-2424 | 2020-07-09 |
| 1083242952 | Julia Andrea Hurtado | Physician Assistant | 3783 Cimarron St, Los Angeles, CA 90018-4463 | 2020-03-27 |
| 1174150130 | Susan C. Williams | Physician Assistant | 2215 Alcazar St, Los Angeles, CA 90033-1003 | 2020-03-26 |
| 1720615776 | Shannon Hakakeyan | Physician Assistant | 1580 Manning Ave Apt 303, Los Angeles, CA 90024-6086 | 2020-03-26 |
| 1952938243 | Jayanti Sharma | Physician Assistant | 1515 Amherst Ave Apt 303, Los Angeles, CA 90025-3677 | 2020-03-25 |
| 1669008058 | Michelle Ji Hye Chang | Physician Assistant | 360 W Avenue 26 Apt 423, Los Angeles, CA 90031-1490 | 2020-03-17 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90004 |
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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.