GRACE PARK (NPI# 1306386610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306386610 |
| Entity Type | Individual |
| Full Name | GRACE PARK |
| Practice Address |
740 W Alluvial Ave Suite 101 Fresno CA 93711-5509 |
| Mailing Address |
14632 Fairvilla Dr La Mirada CA 90638-2909 |
| Practice Telephone | 8007973543 |
| Mailing Telephone | 7147456774 |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 76225 | CA | Pharmacy Service Providers |
| 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 |
| 1164677464 | Grace Jiyoung Park | Family Medicine | 15446 S. Western Ave, Southern California Permanente Medical Group, Gardena, CA 90249 | 2008-12-01 |
| 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 |
| Street Address |
740 W ALLUVIAL AVE SUITE 101 |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-5509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023116027 | Brenda Denice Riser | Pharmacist | 740 W Alluvial Ave, Ste 101, Fresno, CA 93711-5509 | 2006-09-21 |
| 1902308075 | Clint Auttapibarn | Pharmacist | 740 W Alluvial Ave, Fresno, CA 93711-5509 | 2018-03-05 |
| 1679004881 | Robert Madrigal | Pharmacist | 740 W Alluvial Ave, Fresno, CA 93711-5509 | 2017-03-21 |
| 1184160889 | Lisa Nguyen | Pharmacist | 740 W Alluvial Ave, Suite 101, Fresno, CA 93711-5509 | 2017-01-18 |
| 1902358179 | Elizabeth Klueger | Pharmacist | 740 W Alluvial Ave, Suite 101, Fresno, CA 93711-5509 | 2016-11-03 |
| 1235681271 | Donnya Heyward | Pharmacist | 740 W Alluvial Ave, Suite 101, Fresno, CA 93711-5509 | 2016-10-25 |
| 1073068623 | Rena Sheng | Pharmacist | 740 W Alluvial Ave, Fresno, CA 93711-5509 | 2016-08-23 |
| 1700234598 | Lendy Le | Pharmacist | 740 W Alluvial Ave, Suite 101, Fresno, CA 93711-5509 | 2016-06-02 |
| 1902265713 | Monica Dulwick | Pharmacist | 740 W Alluvial Ave, Suite 101, Fresno, CA 93711-5509 | 2016-02-22 |
| 1912366261 | Bernard Lau | Pharmacist | 740 W Alluvial Ave, #101, Fresno, CA 93711-5509 | 2016-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104464684 | Kazi Shafiul Moula | Dentist | Western Dental/ Brident 150bfo, 3077 W Shaw Ave, Fresno, CA 93711 | 2019-12-16 |
| 1760037063 | Armine Petrosyan | Nurse Practitioner | 427 W Beford Ave Suite 103, Fresno, CA 93711 | 2019-08-05 |
| 1912489360 | Shoua Nelson | Nurse Practitioner | 2490 W. Shaw Avenue Suite 101, Fresno, CA 93711 | 2018-09-02 |
| 1245725506 | Promesa Behavioral Health-barstow | Community Based Residential Treatment Facility, Mental Illness | 1415 W Barstow Ave, Fresno, CA 93711 | 2018-06-28 |
| 1407344138 | Aidan Mechem | Behavior Technician | 5140 N. Fruit Avene, Fresno, CA 93711 | 2018-04-27 |
| 1841798840 | Michael Ramos IIi | Behavior Technician | 1690 N Shaw Ave, 102, Fresno, CA 93711 | 2018-01-25 |
| 1962913467 | Dhara Devendrakumar Patel | Pharmacist | 740 West Alluvial Avenue, Suite 101, Fresno, CA 93711 | 2017-10-24 |
| 1588183636 | Bianca Arteaga | Counselor | 7485 N. Palm Ave., Suite 103, Fresno, CA 93711 | 2017-09-10 |
| 1346763158 | Powell Pediatric Dentistry Ingram Partnership | Dentist | 7761 N Ingram Ave, Suite 101, Fresno, CA 93711 | 2017-07-24 |
| 1982124202 | Justine Syera Balbas | Counselor | 2766 W. Celeste Ave., Unit 103, Fresno, CA 93711 | 2017-06-27 |
| Find all providers in zip 93711 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174163174 | Michael Krage | Pharmacist | 1302 Fulton St, Fresno, CA 93721-1608 | 2020-01-08 |
| 1417595711 | Alexis Mozelle Lolita Woods | Pharmacist | 5348 E Heaton Ave, Fresno, CA 93727-5252 | 2019-12-17 |
| 1154966588 | Vy T Tran | Pharmacist | 261 E Braddock Dr, Fresno, CA 93720-0826 | 2019-11-08 |
| 1831750413 | Nancy Lam | Pharmacist | 7112 N Fresno St Ste 460, Fresno, CA 93720-2947 | 2019-06-25 |
| 1710545322 | Vijay S Dalvi | Pharmacist | 6055 N Brawley Ave, Apt 235, Fresno, CA 93722 | 2019-05-30 |
| 1306409792 | Golnoosh Dalili | Pharmacist | 1349 E Via Roma Dr, Fresno, CA 93730-8800 | 2019-04-21 |
| 1104489814 | Jaime Bautista Bautista | Pharmacist | 7762 N Princess Ave, Fresno, CA 93722-2231 | 2019-04-18 |
| 1801359286 | Madlen Rizkallah | Pharmacist | 7090 N Refinement Dr, Fresno, CA 93711-0291 | 2019-04-11 |
| 1346714375 | Maha Mhaissen | Pharmacist | 2272 E Prestwick Ave, Fresno, CA 93730-5958 | 2019-01-12 |
| 1851867386 | Cuihong Zhai Leung | Pharmacist | 525 E Mariners Cir, Fresno, CA 93730-0848 | 2018-10-23 |
| Find all providers in FRESNO | ||||
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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.