DR. JUNG WON PARK (NPI# 1184756082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184756082 |
| Entity Type | Individual |
| Full Name | DR. JUNG WON PARK |
| Other Name | JAY WON PARK |
| Credential | M.D. |
| Practice Address |
7215 55th St Sacramento CA 95823-2601 |
| Mailing Address |
200 Oceangate Suite 100 Long Beach CA 90802-4317 |
| Practice Telephone | 9163991100 |
| Practice Fax Number | 8778602397 |
| Mailing Telephone | 5624996191 |
| Mailing Fax Number | 8778602397 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2017-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | C56214 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | G9781 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 89C759 | 01 |
| CA | RR MEDICARE | P01758328-DV5277 | 01 |
| TX | 118238804 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225569817 | Jung Park | Student in an Organized Health Care Education/Training Program | 255 Whitney Ave Apt 34, New Haven, CT 06511-3751 | 2017-03-24 |
| 1336681238 | Jung Park | Acupuncturist | 308 Preston Ave, Pasadena, TX 77503-1215 | 2016-11-08 |
| 1275783813 | Jung Sun Park | Dentist | 1860 Alcatraz, Berkeley, CA 94703 | 2008-09-19 |
| 1194919209 | Jung Hoon Park | Dentist | 5249 Duke St Ste 210, Alexandria, VA 22304-2907 | 2007-08-31 |
| 1124006523 | Jung I. Park | Specialist | 8825 Crestwood Ave, Munster, IN 46321-2711 | 2006-01-05 |
| 1942291638 | Jung Tae Park | Family Medicine | 13851 Highway 28, Whitwell, TN 37397-5373 | 2005-11-02 |
| 1679004873 | Jung Mi Park | Hospitalist | 49 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3049 | 2017-03-21 |
| 1417302621 | Jung Park | Technician/Technologist | 11112 Atlantic Ave, South Richmond Hill, NY 11419-1158 | 2016-04-26 |
| 1053601161 | Jung Eun Park | Pediatrics | 6345 Center Dr Bldg 14, Norfolk, VA 23502-4105 | 2011-04-10 |
| 1174855738 | Jung Park | Internal Medicine | 8110 Woodman Ave, Panorama City, CA 91402 | 2010-02-08 |
| Street Address |
7215 55TH ST |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95823-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912915539 | Joshua Hoover | Social Worker | 7215 55th St, Sacramento, CA 95823-2601 | 2006-08-03 |
| 1699134676 | Barbara Anne Hull | Family Medicine | 7215 55th St, Sacramento, CA 95823-2601 | 2016-02-18 |
| 1578965315 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 7215 55th St, Sacramento, CA 95823-2601 | 2014-09-24 |
| 1164835344 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 7215 55th St, Sacramento, CA 95823-2601 | 2014-06-05 |
| 1073628202 | Molina Healthcare of California | Internal Medicine | 7215 55th St, Sacramento, CA 95823-2601 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343422 | Renee Yvonne Friesner | Registered Nurse | 6965 65th Street, Sacramento, CA 95823 | 2020-10-12 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1114562766 | Daniel & Max, LLC | Optometrist | 4200 Florin Road, Suite C, Florin, CA 95823 | 2019-11-07 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1306316880 | Evin Johnson | Case Manager/Care Coordinator | 7000 Franklin Blvd Suite 625, Sacramento, CA 95823 | 2018-11-28 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1891298923 | Nicholas Joseph Henderson | Behavior Technician | 6500 47th Street Apt#76, Sacramento, CA 95823 | 2018-03-15 |
| 1427567098 | Luz Maria Udave | Behavior Technician | 5435 Mack Rd Apt 87, Sacramento, CA 95823 | 2017-09-26 |
| 1417474743 | Elizabeth Smithers | Behavior Technician | 5545 Sky Parkway #202, Sacramento, CA 95823 | 2017-08-28 |
| Find all providers in zip 95823 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374904 | Ollie Health Medical Group, Inc. | Pediatrics | 9700 Business Park Dr Ste 406, Sacramento, CA 95827-1718 | 2020-04-14 |
| 1093353195 | East Sacramento Pediatric Medical Group Inc | Pediatrics | 5030 J St Ste 301, Sacramento, CA 95819-3800 | 2019-12-19 |
| 1992206544 | Brittany Michelle Mcgregor | Pediatrics | 7237 E Southgate Dr Ste A, Sacramento, CA 95823-2637 | 2018-02-27 |
| 1528440708 | Adrienne Hoyt-austin | Pediatrics | 2103 Stockton Blvd, Sacramento, CA 95817-1354 | 2015-06-23 |
| 1043618689 | Zachary Chaffin | Pediatrics | 2516 Stockton Blvd Ste 216, Sacramento, CA 95817-2208 | 2014-12-14 |
| 1316363104 | Howard N Futerman | Pediatrics | 1618 Alhambra Blvd Unit 160546, Sacramento, CA 95816-7622 | 2014-03-17 |
| 1063755932 | Joan Manansala Villaflor | Pediatrics | 7501 Hospital Dr Ste 203, Sacramento, CA 95823-5405 | 2013-03-29 |
| 1972847747 | Lauren E Wilson | Pediatrics | 425 University Avenue, Suite 200, Sacramento, CA 95825 | 2012-11-19 |
| 1982954103 | Virgina Lee | Pediatrics | 1111 Exposition Blvd # 700, Suite 102, Sacramento, CA 95815-4314 | 2012-09-14 |
| 1508113390 | Garrett Hau Sheng | Pediatrics | 1625 Stockton Blvd Ste 106, Sacramento, CA 95816-7098 | 2012-08-10 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95823 |
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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.