BRUCE PARK, M.D. A PROFESSIONAL CORPORATION (NPI# 1851478358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851478358 |
| Entity Type | Organization |
| Organization Name | BRUCE PARK, M.D. A PROFESSIONAL CORPORATION |
| Other Organization Name | BRUCE PARK MD |
| Practice Address |
1966 E Chapman Ave Suite G Fullerton CA 92831-4142 |
| Practice Telephone | 7145250545 |
| Mailing Telephone | 7145620542 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-06-05 |
| Authorized Official Name | DR. BRUCE S PARK (CEO) |
| Authorized Official Telephone | 7145250545 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| bruce park md | Former Legal Business Name - Organization |
| Street Address |
1966 E CHAPMAN AVE SUITE G |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831-4142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447597208 | J.j.kim Acupuncture Clinic PC | Acupuncturist | 1966 E Chapman Ave, Suite J, Fullerton, CA 92831-4142 | 2013-01-12 |
| 1659656163 | Jong Joung Kim | Acupuncturist | 1966 E Chapman Ave, Suite J, Fullerton, CA 92831-4142 | 2011-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| Find all providers in zip 92831 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710046628 | David J. Sire | Dermatology | 301 W Bastanchury Rd Ste 140, Fullerton, CA 92835 | 2006-12-06 |
| 1841378825 | Bruce S Park | Dermatology | 1966 E Chapman Ave Ste G, Fullerton, CA 92831-4141 | 2006-11-01 |
| 1548274996 | Amy Ngoc Nguyen | Dermatology | 2720 N Harbor Blvd Ste 205, Fullerton, CA 92835-2609 | 2006-07-28 |
| 1710917513 | Edward E Aston Iv | Dermatology | 333 W Bastanchury Rd, Suite 110, Fullerton, CA 92835-3420 | 2006-07-04 |
| 1194772822 | Kristina A Holmkvist | Dermatology | 301 W Bastanchury Road, Suite 245, Fullerton, CA 92835 | 2006-05-28 |
| 1588665392 | Tobey Wu-kuo | Dermatology | 2720 N Harbor Blvd Ste 210, Fullerton, CA 92835-2626 | 2005-08-02 |
| 1699265868 | Diakoniamed | Dermatology | 2720 N Harbor Blvd Ste 205, Fullerton, CA 92835-2609 | 2018-05-14 |
| 1083024681 | Jennifer Ledon | Dermatology | 1440 N Harbor Blvd Ste 300, Fullerton, CA 92835-4116 | 2014-05-05 |
| 1013283910 | Helia Eragi | Dermatology | 301 W Bastanchury Rd, Suite 210, Fullerton, CA 92835-3419 | 2012-03-26 |
| 1023272309 | Khaled Mahmoud Hassan | Dermatology | 2720 N Harbor Blvd, Ste 220, Fullerton, CA 92835-2609 | 2008-07-15 |
| Find all providers in FULLERTON | ||||
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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.