TAE J. PARK (NPI# 1346297660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346297660 |
| Entity Type | Individual |
| Full Name | TAE J. PARK |
| Credential | M.D. |
| Practice Address |
512 W Rosedale St Fort Worth TX 76104-4619 |
| Mailing Address |
12900 Park Plaza Dr Ste 150 Cerritos CA 90703-9329 |
| Practice Telephone | 5626772414 |
| Practice Fax Number | 5627414479 |
| Mailing Telephone | 5629774674 |
| Mailing Fax Number | 5627414479 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | S1480 | TX | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | A90047 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A900470 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710273156 | Tae Sook Park | Acupuncturist | 903 S. Crenshaw Blvd, 302, Los Angeles, CA 90019 | 2011-06-23 |
| 1790870996 | Tae H Park | Dentist | 1875 E Alluvial Ave, Suite 102, Fresno, CA 93720-3856 | 2006-10-04 |
| 1336230259 | Tae K Park | Internal Medicine | 724 8th Ave, Brooklyn, NY 11215-4204 | 2006-09-27 |
| 1376560805 | Tae Sung Park | Neurological Surgery | 1 Childrens Pl Fl 1, 1st Fl, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1538133020 | Tae Won Park | Psychiatry & Neurology | 1547 S Wayne Rd, Westland, MI 48186 | 2006-02-14 |
| 1275015364 | Tae Park | Pharmacist | 1640 Hopkins Rd, Williamsville, NY 14221-1752 | 2018-09-05 |
| 1669751772 | Tae E Park | Pharmacist | 230 Park Ave, M-sp1-01, Florham Park, NJ 07901 | 2011-08-05 |
| 1093940249 | Tae Keun Park | Emergency Medicine | 300 Community Dr, Department of Emergency Medicine, Manhasset, NY 11030-3816 | 2009-05-18 |
| 1043308984 | Tae Park | Pharmacist | 1450 Chapel St, Pharmacy Department, New Haven, CT 06511-4405 | 2006-10-10 |
| 1932141942 | Tae Park | Radiology | University Hospital L2, Stony Brook, NY 11794-0001 | 2006-06-12 |
| Street Address |
512 W ROSEDALE ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144721432 | Caremore Medical Associates Pllc | Internal Medicine | 512 W Rosedale St, Fort Worth, TX 76104 | 2018-02-22 |
| 1639533953 | Mary Wilson | Nurse Practitioner | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2016-04-12 |
| 1912382375 | Indus Dental Associates, P.C. | Dentist | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2015-07-28 |
| 1275965949 | Belinda Chandara Hong Mang | Pharmacist | 512 W Rosedale St, Fort Worth, TX 76104 | 2013-08-05 |
| 1588911705 | Ket Harris Davis | Nurse Practitioner | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2012-08-07 |
| 1730479668 | Zenobia L Newman | Nurse Practitioner | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2011-04-12 |
| 1396059069 | Vibin Roy | Family Medicine | 512 W Rosedale St, Fort Worth, TX 76104 | 2010-08-04 |
| 1992016919 | Neil Nayan Shah | Internal Medicine | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2010-06-24 |
| 1568692986 | Olasumbo T. Afilaka | Nurse Practitioner | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2009-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023581006 | Leon S Tio Md Pa | Internal Medicine | 800 8th Ave Ste 336, Fort Worth, TX 76104-2614 | 2019-01-02 |
| 1174009385 | Universal Clinical Care LLC. | Internal Medicine | 2502 Via Nicola Apt 3424, Fort Worth, TX 76109-5587 | 2018-07-11 |
| 1417458068 | Fort Worth Primary Care, Pllc | Internal Medicine | 800 8th Ave Ste 626, Fort Worth, TX 76104-2605 | 2018-02-27 |
| 1750753976 | Momentum Health Partners Pllc | Internal Medicine | 4551 Boat Club Rd, Fort Worth, TX 76135-2004 | 2015-10-27 |
| 1013399286 | Aman Kanti Patel | Internal Medicine | 2502 Via Nicola, Apt # 3424, Fort Worth, TX 76109-6566 | 2015-06-24 |
| 1053705855 | Deidi Ann Bergestuen | Internal Medicine | 5450 Clearfork Main Street Suite 300, Fort Worth, TX 76109-7208 | 2015-03-19 |
| 1992198188 | Jack Ni | Internal Medicine | Baylor Scott & White All Saints Medical Center, 1400 8th Ave, Fort Worth, TX 76104-4192 | 2015-03-11 |
| 1184054066 | Dfw Premier Healthcare Pa | Internal Medicine | 4844 Sangers Ct, Fort Worth, TX 76244-9119 | 2013-11-14 |
| 1588094593 | T Off Men's Health | Internal Medicine | 601 Penn St, Fort Worth, TX 76102-2619 | 2013-11-13 |
| 1174957054 | Medhealth Center Inc | Internal Medicine | 112 Nw 24th St Ste 206, Fort Worth, TX 76164-8577 | 2013-08-27 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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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.