SOO PARK (NPI# 1821351198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821351198 |
| Entity Type | Individual |
| Full Name | SOO PARK |
| Credential | M.D. |
| Practice Address |
Moores Ucsd Cancer Ctr 3855 Health Sciences Drive, Mc-0829 La Jolla CA 92093-0829 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 8586575281 |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2020-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 2012019698 | MO | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
135455 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 W Arbor Dr, San Diego, CA 921039000 | 8009268273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376669812 | Soo Min Park | Social Worker | 1310 Wilshire Blvd, Los Angeles, CA 90017-1705 | 2007-03-22 |
| 1609819226 | Soo H. Park | Internal Medicine | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2006-06-13 |
| 1124084728 | Soo Tae Park | Dentist | 44841 N 10th St W, Lancaster, CA 93534 | 2006-04-22 |
| Street Address |
MOORES UCSD CANCER CTR 3855 HEALTH SCIENCES DRIVE, MC-0829 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92093-0829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649255621 | Elisabeth C Mclemore | Colon & Rectal Surgery | Moores Ucsd Cancer Ctr, 3855 Health Sciences Drive, La Jolla, CA 92093-0001 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902442908 | Forrest N Ridgway | Pharmacist | 3855 Health Sciences Drive #0845, La Jolla, CA 92093 | 2019-11-25 |
| 1578060067 | Michelle Sloan | Student in an Organized Health Care Education/Training Program | 9500 Gilman Dr #0851, La Jolla, CA 92093 | 2018-04-10 |
| 1114372471 | Kevin Ting | Internal Medicine | 9500 Gilman Dr # Mc7411, La Jolla, CA 92093 | 2016-04-24 |
| 1225490147 | Karen Tye | Student in an Organized Health Care Education/Training Program | 3960 Health Sciences Drive, La Jolla, CA 92093 | 2016-03-22 |
| 1457716615 | Christine Pulido | Student in an Organized Health Care Education/Training Program | 9500 Gilman Drive #0851, La Jolla, CA 92093 | 2015-12-15 |
| 1467830489 | Justin Arshed Shaya | Internal Medicine | 3855 Health Sciences Dr #0829, La Jolla, CA 92093 | 2015-05-11 |
| 1225425606 | Brad Hiroshi Kimura | Internal Medicine | 9500 Gilman Dr # Mc9111g, La Jolla, CA 92093 | 2015-04-23 |
| 1407241169 | Courtney Holmes Mckee | Emergency Medicine | 3855 Health Sciences Drive Mc0987, La Jolla, CA 92093 | 2015-03-31 |
| 1528488350 | Arlene Bravo | General Practice | 9500 Gilman Dr # Mc0656, La Jolla, CA 92093 | 2014-04-19 |
| 1710237391 | Chaitanya Pabbati | Psychiatry & Neurology | 9500 Gillman Drive #9116a, La Jolla, CA 92093 | 2012-09-11 |
| Find all providers in zip 92093 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467830489 | Justin Arshed Shaya | Internal Medicine | 3855 Health Sciences Dr #0829, La Jolla, CA 92093 | 2015-05-11 |
| 1679816805 | Zhubin J Gahvari | Internal Medicine | 10710 N Torrey Pines Rd # Ms 312, La Jolla, CA 92037-1035 | 2013-04-06 |
| 1760778526 | Rebecca Arielle Shatsky | Internal Medicine | 3855 Health Sciences Dr # Mc0829, Moores Cancer Center Dept of Hematology/oncology, La Jolla, CA 92093-0829 | 2011-06-21 |
| 1861784993 | Akram Mesleh Shayeb | Internal Medicine | Ucsd Health, 3855 Health Sciences Dr #0829, La Jolla, CA 92093-0829 | 2011-05-09 |
| 1831323369 | Srila Gopal | Internal Medicine | 9500 Gilman Dr # Mc0878, La Jolla, CA 92093 | 2009-05-12 |
| 1144431230 | Ayad Hamdan | Internal Medicine | 3855 Health Sciences Dr # 960, La Jolla, CA 92093-1503 | 2007-05-24 |
| 1043337173 | Imawati Budihardjo | Internal Medicine | 3855 Health Sciences Dr # 0658, La Jolla, CA 92093-0987 | 2007-03-23 |
| 1598841561 | Ewa K Carrier | Internal Medicine | 3855 Health Sciences Drive #0960, La Jolla, CA 92093-0960 | 2006-10-31 |
| 1346801289 | Compassion Breast Inc | Internal Medicine | 9888 Genesee Ave, La Jolla, CA 92037-1205 | 2019-06-21 |
| 1679935639 | Ann Marie Moeller | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2016-03-28 |
| Find all providers in LA JOLLA | ||||
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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.