DR. JUN TAE PARK


Address: 11100 Euclid Ave, Cleveland, OH 44106-1716
Phone: 2168447700

DR. JUN TAE PARK (NPI# 1437333515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437333515
Entity Type Individual
Full Name DR. JUN TAE PARK
Credential M.D.
Practice Address 11100 Euclid Ave
Cleveland
OH 44106-1716
Mailing Address 24701 Euclid Ave
3rd Floor
Euclid
OH 44117-1714
Practice Telephone 2168447700
Enumeration Date 2007-12-24
Last Update Date 2013-05-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084N0402X Psychiatry & Neurology
Specialization: Neurology with Special Qualifications in Child Neurology
35-097398 OH Allopathic & Osteopathic Physicians
N 2084N0402X Psychiatry & Neurology
Specialization: Neurology with Special Qualifications in Child Neurology
5922577-1205 UT Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OH 0063239 05

Other Providers JUN PARK

NPI Name Taxonomy Address Enumeration
1043744279 Jun Park Internal Medicine 4150 V Street, Pssb, Suite G400, Sacramento, CA 95817 2017-04-13
1548443831 Jun Young Park Dentist 2030 Liberty Rd Ste 1, Eldersburg, MD 21784-6129 2007-12-10
1922578962 Jun Hong Park Case Manager/Care Coordinator 600 St Paul Ave Ste 101, Los Angeles, CA 90017-5660 2018-12-03
1831687730 Jun Park Pharmacist 711 Pier Ave, Hermosa Beach, CA 90254-3941 2018-04-25
1275858672 Jun Park Pharmacist 500 Indiana Ave, Winslow, AZ 86047-2169 2010-03-29
1891022752 Jun Sang Park Chiropractor 704 Dekalb Pike, Blue Bell, PA 19422-1214 2009-11-12
1952540908 Jun Kyu Park Anesthesiology 7300 Medical Center Dr, West Hills, CA 91307-1902 2009-02-16
1497925739 Jun Hyeong Park Dentist 2710 Telegraph Ave, 250, Oakland, CA 94612 2008-03-03
1063553022 Jun Park Dentist 4141 State St, Suite C-2 Dental, Santa Barbara, CA 93110-1814 2007-02-10

Office Location

Street Address 11100 EUCLID AVE
City CLEVELAND
State OH
Zip Code 44106-1716

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801899927 Joel H. Elconin Radiology 11100 Euclid Ave, Ireland/seidman Radiation Oncology, Cleveland, OH 44106 2005-05-23
1386245207 Dalal Hamad A Alsaggabi Student in an Organized Health Care Education/Training Program 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-11-06
1922609809 Melanie Wolf Registered Nurse 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-11-05
1093313918 Aryn Rose Pecoraro Nurse Practitioner 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-10-13
1366058331 Harun Abukar Registered Nurse 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-09-16
1205442290 Jessica Regan Dietitian, Registered 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-09-16
1740895960 Sara Lyn Stefano Nurse Practitioner 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-09-14
1063026052 Meredith Barker Nurse Practitioner 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-09-07
1124631114 Luis Augusto Palma Dallan Student in an Organized Health Care Education/Training Program 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-08-28
1023621216 Stephanie Casto Nurse Practitioner 11100 Euclid Ave, Cleveland, OH 44106-1716 2020-08-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295347706 Adeeb Oweidat Anesthesiology 1999 Circle Drive Centric, Apartment 417, Cleveland, OH 44106 2020-08-18
1104434240 Bradly Miner Student in an Organized Health Care Education/Training Program Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106 2020-07-15
1306466974 Ho Jun Lee Student in an Organized Health Care Education/Training Program 11100 Euclid Ave University Hospitals Cleveland Medical, Cleveland, OH 44106 2020-04-23
1528687837 Shaleeka Cornelius Student in an Organized Health Care Education/Training Program 11100 Euclid Avenue Han 5042, University Hospitals Cleveland Medical Center, Cleveland, OH 44106 2020-04-16
1598393175 Mikdat Ulas Student in an Organized Health Care Education/Training Program 111000 Euclid Avenue, Cleveland, OH 44106 2020-03-30
1790335651 Michelle Clark Home Health Aide 1794 E 87th St, Cleveland, OH 44106 2019-09-12
1881246783 Oziel Valdez Sanchez Student in an Organized Health Care Education/Training Program 11900 Euclid Ave, Cleveland, OH 44106 2019-07-10
1487216842 Betina Griens Porto Dentist 9601 Chester Avenue, Case Western Reserve School of Dental Medicine, Cleveland, OH 44106 2019-07-05
1407417140 Rebecca Petts Dentist 9601 Chester Ave, Cleveland, OH 44106 2019-06-24
1023677259 Moeen Al Weshah Student in an Organized Health Care Education/Training Program 9601 Chester Ave # 239j3, Cleveland, OH 44106 2019-06-11
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Taxonomy Information

Taxonomy Code 2084N0402X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Neurology with Special Qualifications in Child Neurology

Taxonomy Definition

A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477728517 Ahsan Moosa Naduvil Valappil Psychiatry & Neurology 2680 N Moreland Blvd, Apt 605, Cleveland, OH 44120-1472 2008-04-29
1265512669 Stephen Maricich Psychiatry & Neurology 10900 Euclid Avenue, Case Western Reserve University Som Room E750i, Cleveland, OH 44106 2006-10-17
1881094142 David Francois-xavier Dufresne Psychiatry & Neurology 9500 Euclid Ave, Epilepsy Center, Cleveland, OH 44195-0001 2014-08-23
1942640842 Stephen Steiner Psychiatry & Neurology 11100 Euclid Ave, Cleveland, OH 44106 2013-06-25
1902198104 Jennifer Leigh Waldron Psychiatry & Neurology 11100 Euclid Ave, Cleveland, OH 44106-1716 2011-05-05
1154501989 Dararat Mingbunjerdsuk Psychiatry & Neurology 11100 Euclid Ave, Cleveland, OH 44106-1716 2007-11-08
1215142674 Elia Margarita Pestana Knight Psychiatry & Neurology 9500 Euclid Ave, Cleveland, OH 44195-1716 2007-05-11
1962616730 Asim Mohammad Shahid Psychiatry & Neurology 11100 Euclid Ave, Cleveland, OH 44106-1716 2007-05-10
1295803641 Elie Rizkala Psychiatry & Neurology 2500 Metrohealth Dr, Mhmc-pediatrics, Cleveland, OH 44109-1900 2006-12-02
1922021971 Deborah Rukin Gold Psychiatry & Neurology 11100 Euclid Ave, Cleveland, OH 44106-1716 2006-07-25
Find all providers in CLEVELAND

Competitor

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City CLEVELAND
Zip Code 44106

Improve Information

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Dataset Information

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.

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