ROBERT PARK M.D. (NPI# 1538356035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538356035 |
| Entity Type | Organization |
| Organization Name | ROBERT PARK M.D. |
| Practice Address |
191 Lynch Creek Way Suite 205 Petaluma CA 94954-2389 |
| Practice Telephone | 7077651501 |
| Practice Fax Number | 7077651530 |
| Mailing Telephone | 7077651501 |
| Mailing Fax Number | 7077651530 |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-10-10 |
| Authorized Official Name | DR. ROBERT PARK (OWNER) |
| Authorized Official Telephone | 7077651501 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
G22984 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
191 LYNCH CREEK WAY SUITE 205 |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-2389 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013338086 | Parinaz Azari Md Inc | Pain Medicine | 191 Lynch Creek Way, Suite 101, Petaluma, CA 94954-2376 | 2013-12-18 |
| 1588937684 | Sequoia Senior Solutions, Inc. | In Home Supportive Care | 191 Lynch Creek Way, Suite 102, Petaluma, CA 94954-2376 | 2012-02-21 |
| 1902109960 | Kevin Barkley Linzey | Chiropractor | 191 Lynch Creek Way, Ste 201, Petaluma, CA 94954-2389 | 2010-12-14 |
| 1538112842 | Robert Park | Internal Medicine | 191 Lynch Creek Way, Suite 205, Petaluma, CA 94954-2389 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1932321387 | Institute for Health Management Inc | Internal Medicine | 715 Southpoint Blvd, Suite C, Petaluma, CA 94954-6835 | 2007-05-03 |
| 1780842724 | Associated Kidney Specialists of The North Bay, Inc. | Internal Medicine | 715 Southpoint Blvd, Suite C, Petaluma, CA 94954-6835 | 2008-05-27 |
| 1962423103 | Farid Osman | Internal Medicine | 108 Lynch Creek Way, Suite, Petaluma, CA 94954-2357 | 2006-07-22 |
| 1538112842 | Robert Park | Internal Medicine | 191 Lynch Creek Way, Suite 205, Petaluma, CA 94954-2389 | 2006-05-18 |
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| 1932745007 | K Care Ipa | Internal Medicine | 18000 Studebaker Rd Ste 100, Cerritos, CA 90703-7929 | 2019-11-22 |
| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1669930723 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 160, Chico, CA 95928-8351 | 2019-03-07 |
| 1295293363 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 220, Chico, CA 95928-8351 | 2019-03-07 |
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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.