Peter S Park (NPI# 1104825033, PAC ID# 3971587353) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1104825033 |
| PAC ID by PECOS | 3971587353 |
| Professional Enrollment ID | I20040614001647 |
| Full Name | Peter S Park |
| Organization Legal Name | PROVIDENCE FOOT AND ANKLE CENTER |
| Address |
3130 W Olympic Blvd Suite 170 Los Angeles CA 90006-2648 |
| Phone Number | 3237327551 |
| Gender | M |
| Credential | DPM |
| Graduation Year | 1995 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 2062568538 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1236 N Magnolia Ave, Anaheim, CA 92801-2607 | 7149951000 | HEALTHCARE PARTNERS AFFILIATES MEDICAL GROUP |
| 3130 W Olympic Blvd, Suite 170, Los Angeles, CA 90006-2648 | 3237327551 | PROVIDENCE FOOT AND ANKLE CENTER |
| Organization Legal Name | PROVIDENCE FOOT AND ANKLE CENTER |
| Physicians | 1 |
| Street Address |
3130 W OLYMPIC BLVD SUITE 170 |
| City | LOS ANGELES |
| State | CA |
| Zip | 90006-2648 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Woo Sung Park | Oral Surgery | 3130 W Olympic Blvd, Suite 320, Los Angeles, CA 90006-2494 | |
| John C Kang | General Surgery | 3130 W Olympic Blvd, Suite 340, Los Angeles, CA 90006-2494 | |
| Hossein Babaali | Internal Medicine | 3130 W Olympic Blvd, Suite 360, Los Angeles, CA 90006-2494 | |
| Man Cho | Psychiatry | 3130 W Olympic Blvd, Suite 370, Los Angeles, CA 90006-2657 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sang H Park | Obstetrics/gynecology | 945 S Western Ave, Suite 100, Los Angeles, CA 90006-1008 | |
| Jun H Lee | Chiropractic | 966 S Western Ave, Suite 201, Los Angeles, CA 90006-1013 | |
| Edward Song Woo Rhee | Podiatry | 966 S Western Ave, Suite 205, Los Angeles, CA 90006-1015 | |
| Jae Y Yoo | Internal Medicine | 966 S Western Ave, Suite 208, Los Angeles, CA 90006-1016 | |
| Kyoung Kwak | Oral Surgery | 981 S Western Ave, Suite 200a, Los Angeles, CA 90006-1080 | |
| Luke Sul | Oral Surgery | 928 S Western Ave, Suite 231, Los Angeles, CA 90006-1083 | |
| Soungdon Chung | Chiropractic | 2140 W Olympic Blvd, Suite 405, Los Angeles, CA 90006-2208 | |
| Myeong C Kim | Physical Medicine and Rehabilitation | 2140 W Olympic Blvd, Suite 210, Los Angeles, CA 90006-2277 | |
| Gene S Han | Ophthalmology | Gene S Han, M.d., Inc. | 3224 W Olympic Blvd, Suite 203, Los Angeles, CA 90006-2317 |
| Song S Cho | Dermatology | Gene S Han, M.d., Inc. | 3224 W Olympic Blvd, Suite 203, Los Angeles, CA 90006-2317 |
| Find all physicians in zip 90006 | |||
| City | LOS ANGELES |
| Zip Code | 90006 |
| Specialty | PODIATRY |
| City + Specialty | LOS ANGELES + PODIATRY |
Please comment or provide details below to improve the information on Peter S Park.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.