DR. GRACE JIYOUNG PARK (NPI# 1164677464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164677464 |
| Entity Type | Individual |
| Full Name | DR. GRACE JIYOUNG PARK |
| Credential | D.O. , MPH |
| Practice Address |
15446 S. Western Ave Southern California Permanente Medical Group Gardena CA 90249 |
| Practice Telephone | 3109654821 |
| Mailing Telephone | 3109654821 |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2010-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 20A10562 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679970859 | Grace Park | Chiropractor | 20627 Golden Springs Dr., 2-b, Diamond Bar, CA 91789 | 2014-12-03 |
| 1710261243 | Grace Eunhye Park | Pharmacist | 125-133 3rd Ave, New York, NY 10003-2543 | 2011-10-03 |
| 1619147592 | Grace Lee Park | Family Medicine | 1109 S. Lincoln Ave., Mckinley Health Center, Urbana, IL 61801 | 2008-03-06 |
| 1033311634 | Grace S Park | Acupuncturist | 7122 Bon Villa Cir, La Palma, CA 90623-1167 | 2007-06-05 |
| 1871602722 | Grace Eunkyoung Park | Dentist | 1024 Sw Highland Dr, #a, Gresham, OR 97080-6353 | 2006-08-30 |
| 1770551954 | Grace E. Park | Pharmacist | 11655 Riverside Dr, North Hollywood, CA 91602-1021 | 2006-03-14 |
| 1639707573 | Grace Park | Student in an Organized Health Care Education/Training Program | 400 W Mineral King Ave, Visalia, CA 93291-6237 | 2020-03-27 |
| 1730739152 | Grace Hyeyoung Park | Pharmacist | 1625 N Campbell Ave, Tucson, AZ 85719-4330 | 2019-09-17 |
| 1407410004 | Grace Park | Student in an Organized Health Care Education/Training Program | 1215 Lee St, Charlottesville, VA 22908-0816 | 2019-04-29 |
| 1275092249 | Grace Eun Park | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-03-18 |
| Street Address |
15446 S. WESTERN AVE SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| City | GARDENA |
| State | CA |
| Zip Code | 90249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821518085 | Jin Taek Limb | Chiropractor | 2911 W 135th Pl, Gardena, CA 90249 | 2017-06-20 |
| 1083084651 | Charde Antoinette | Home Health | 2923 W 138th, Gardena, CA 90249 | 2015-09-25 |
| 1316330145 | Lupita Martinez | Marriage & Family Therapist | 15120 Atkinson Ave Ste 7, Gardena, CA 90249 | 2015-03-18 |
| 1699100487 | Asian American Drug Abuse Program, Inc | Community/Behavioral Health | 14112 S. Kingsley Dr., Gardena, CA 90249 | 2013-09-11 |
| 1992142327 | Vin'ash Coaching, LLC | Private Vehicle | 3163 W 154th Place, Gardena, CA 90249 | 2013-05-24 |
| 1811287048 | Best-option Home Health Agency Inc. | Home Health | 15223 S Crenshaw Blvd Suite A, Gardena, CA 90249 | 2011-04-08 |
| 1356644439 | Ameripride Ambulance Service, Inc. | Ambulance | 13509 South Raymond Avenue, Gardena, CA 90249 | 2010-12-13 |
| 1164732327 | Ctc Healthcare Services Inc | In Home Supportive Care | 13108 Arcturus Avenue, Gardena, CA 90249 | 2010-10-20 |
| 1407170996 | Marl Soon Chung | Dentist | 15622 S. Crenshaw Blvd #b, Gardena, CA 90249 | 2010-03-26 |
| 1215050919 | Gardina Dental Center | Dentist | 15201 S. Western Ave., Gardina, CA 90249 | 2007-04-09 |
| Find all providers in zip 90249 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639717218 | Shaunte E Anderson | Family Medicine | 1025 W 190th St Ste 450, Gardena, CA 90248-4339 | 2019-12-14 |
| 1811497035 | Peyman Banooni Medical Group, Inc | Family Medicine | 1030 Gardena Blvd, Gardena, CA 90247-4956 | 2018-02-14 |
| 1417192063 | Uche Austine Chukwudi | Family Medicine | 15425 Crenshaw Blvd, Gardena, CA 90249-4523 | 2008-12-11 |
| 1831397728 | Felix Uzimwonyi Igbinosa | Family Medicine | 13910 Emerald Ln, Gardena, CA 90247-2497 | 2007-07-03 |
| 1659581932 | Community Family Care Ipa | Family Medicine | 19210 S Vermont Ave Ste 400, Gardena, CA 90248-4431 | 2007-05-23 |
| 1134295132 | Alfonso M Baez | Family Medicine | 14127 South Vermont Avenue, Gardena, CA 90247-2005 | 2006-11-28 |
| 1124042882 | Gholam Reza Hosseinian | Family Medicine | 1030 W Gardena Blvd, Gardena, CA 90247-4956 | 2006-07-27 |
| 1710920756 | Patrick J Lemm | Family Medicine | 15446 S Western Ave, Gardena, CA 90249-4319 | 2006-06-14 |
| 1861446841 | Manoutcher Khalili | Family Medicine | 1146 W Redondo Beach Blvd, Gardena, CA 90247-3538 | 2006-05-22 |
| 1205812500 | Emelou Sagaral | Family Medicine | 1045 W Redondo Beach Blvd Ste 300, La Vida Family Medicine, Gardena, CA 90247-4175 | 2005-12-19 |
| Find all providers in GARDENA | ||||
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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.