EDWARD J PARK (NPI# 1366795106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366795106 |
| Entity Type | Individual |
| Full Name | EDWARD J PARK |
| Credential | D.O. |
| Practice Address |
3771 Katella Ave Ste 210 Los Alamitos CA 90720 |
| Mailing Address |
3771 Katella Ave Ste 210 Los Alamitos CA 90720-3118 |
| Practice Telephone | 5624300581 |
| Practice Fax Number | 5625982110 |
| Mailing Telephone | 5624300581 |
| Mailing Fax Number | 5625982110 |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2019-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 20A17227 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Mullins Dr, Lebanon, OR 973553983 | 5412590200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851420350 | Edward Sung Joon Park | Pharmacist | 5939 Harry Hines Blvd Ste 845, Dallas, TX 75235-6248 | 2007-03-02 |
| 1982678447 | Edward H Park | Physical Therapist | 10080 N Wolfe Rd, Sw3-100, Cupertino, CA 95014-2515 | 2006-02-13 |
| 1285255570 | Edward Park | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-28 |
| 1033669064 | Edward Park | Pharmacist | 18600 S Figueroa St, Gardena, CA 90248-4505 | 2016-10-14 |
| 1811390461 | Edward Park | Dentist | 793 Centre St, Jamaica Plain, MA 02130-2736 | 2014-09-26 |
| 1245640374 | Edward Park | Anesthesiology | 8901 Wisconsin Ave, Walter Reed National Military Medical Center, Bethesda, MD 20889-0004 | 2014-04-29 |
| 1396907317 | Edward Park | Internal Medicine | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2008-07-01 |
| 1790977791 | Edward Chul Park | Dentist | 6950 Ne Campus Way, Hillsboro, OR 97124-5611 | 2007-08-14 |
| 1740368984 | Edward Henry Park | Obstetrics & Gynecology | 800 N Tustin Ave Ste M, Santa Ana, CA 92705-3605 | 2006-11-02 |
| 1447344429 | Edward Hyunjoon Park | Specialist | 1330 San Bernardino Rd, Suite C, Upland, CA 91786-4928 | 2006-10-03 |
| Street Address |
3771 KATELLA AVE STE 210 |
| City | LOS ALAMITOS |
| State | CA |
| Zip Code | 90720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194816892 | Coast Urological Medical Group, Inc. | Urology | 3771 Katella Ave Ste 210, Los Alamitos, CA 90720 | 2006-09-27 |
| 1437393303 | Alexa Y Chai | Urology | 3771 Katella Ave Ste 210, Los Alamitos, CA 90720-3118 | 2009-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871152132 | Connie Lee Wax | Social Worker | 5182 Katella, Suite 206, Los Alamitos, CA 90720 | 2019-06-11 |
| 1750891446 | Angela Lynn Hudson | Nurse Practitioner | 4281 Katella Ave Ste 215, Los Alamitos, CA 90720 | 2017-10-06 |
| 1922524149 | Tigom LLC | Pharmacy | 4434 Cerritos Ave, Los Alamitos, CA 90720 | 2017-08-18 |
| 1821531401 | Added Access Cardiology Inc | Internal Medicine | 3801 Katella Ave Suite 401, Los Alamitos, CA 90720 | 2016-11-30 |
| 1619348091 | Debbie Chen | Marriage & Family Therapist | 5182 Katella Ave Ste 202, Los Alamitos, CA 90720 | 2015-10-12 |
| 1801292974 | Michelle R. Ancharoff | Psychologist | 4281 Katella Ave #122, Los Alamitos, CA 90720 | 2014-11-17 |
| 1497179253 | Jeffrey J Mccullough | Dentist | 4281 Katella Ave Ste 112, Los Alamitos, CA 90720 | 2014-02-13 |
| 1043634124 | Alamitos Oral Surgery | Dentist | 4582 Katella Avenue, Los Alamitos, CA 90720 | 2014-02-11 |
| 1972939718 | Twin Town Corporation | Clinic/Center | 4376 Katella Ave., Los Alamitos, CA 90720 | 2013-09-25 |
| 1952644197 | Lindsay Enebak Mossinger | Internal Medicine | 3851 Katella Ave Ste 220, Los Alamitos, CA 90720 | 2013-04-05 |
| Find all providers in zip 90720 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194816892 | Coast Urological Medical Group, Inc. | Urology | 3771 Katella Ave Ste 210, Los Alamitos, CA 90720 | 2006-09-27 |
| 1659489268 | Henry H Wu | Urology | 3801 Katella Ave Ste 320, Los Alamitos, CA 90720-3338 | 2006-08-25 |
| 1841202074 | Associates In Urology A Medical Corporation | Urology | 3791 Katella Ave Ste 200, Los Alamitos, CA 90720-2016 | 2006-08-13 |
| 1437393303 | Alexa Y Chai | Urology | 3771 Katella Ave Ste 210, Los Alamitos, CA 90720-3118 | 2009-04-23 |
| 1992884738 | Robert G Pugach Md Inc | Urology | 3801 Katella Ave, #110, Los Alamitos, CA 90720 | 2006-11-03 |
| 1518063510 | Ruben Baghdassarian | Urology | 3791 Katella Ave, Suite 200, Los Alamitos, CA 90720-3105 | 2006-09-16 |
| 1699871608 | Stuart Alexander Chalfin | Urology | 3791 Katella Ave, Suite 200, Los Alamitos, CA 90720-3105 | 2006-09-16 |
| 1104888759 | Southern California Urology, Inc. | Urology | 3801 Katella Ave, Suite 320, Los Alamitos, CA 90720-3338 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033096 | Urology Surgical Partners | Urology | 15944 Los Serranos Country Club Dr Ste 200, Chino Hills, CA 91709-3991 | 2020-11-06 |
| 1891301487 | Fadl Hamouche | Urology | 400 Parnassus Ave # A632, San Francisco, CA 94143-2202 | 2020-09-18 |
| 1083233902 | Elite Medical Group PC | Urology | 2083 Compton Ave Ste 202, Corona, CA 92881-3416 | 2020-04-10 |
| 1659919660 | Thrive Medical, Inc. | Urology | 18740 Ventura Blvd Ste 101, Tarzana, CA 91356-3366 | 2019-12-20 |
| 1457997645 | David G Song Md Inc | Urology | 5365 Walnut Avenue Ste A, Chino, CA 91710-9171 | 2019-11-21 |
| 1699316273 | Golden Gate Urology Inc | Urology | 929 Clay St Ste 505, San Francisco, CA 94108-1500 | 2019-10-04 |
| 1598318461 | Khoddami Medical Group Inc | Urology | 2705 Loma Vista Rd Ste 206, Ventura, CA 93003-1584 | 2019-07-19 |
| 1942760293 | Adventist Health Physicians Network | Urology | 2701 Chester Ave # 102, Bakersfield, CA 93301-2016 | 2019-03-22 |
| 1699233361 | Orange Coast Medical, A Medical Corporation | Urology | 10900 Warner Ave Ste 121, Fountain Valley, CA 92708-3846 | 2019-03-12 |
| 1891268389 | John Joseph Granato Jr. | Urology | 333 Cumberland Rd, Glendale, CA 91202-1256 | 2019-01-07 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMITOS |
| Zip Code | 90720 |
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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.