TONY JUNGWOO PARK NPI 1144686577

NPI Information

  • NPI: 1144686577
  • Provider Name: TONY JUNGWOO PARK
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7212 ORANGETHORPE AVE STE 9A
    BUENA PARK, CA
    ZIP 90621
  • Phone: (714) 503-6550

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NPI Details

Tony Jungwoo Park is a psychiatric/mental health nurse practitioner in Buena Park, CA with 5 years of experience. Tony Jungwoo Park NPI is 1144686577. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA
ZIP 90621-668
Phone: (714) 503-6550
Fax: (714) 409-3075

The NPI 1144686577 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/14/2016 and was last updated on 11/4/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse835101CALIFORNIANo
2363LF0000XNurse PractitionerFamily95003723CALIFORNIANo
3363LP0808XNurse PractitionerPsychiatric/Mental Health2020011541CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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