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BEAU YUN PARK M.D. NPI 1184914046


NPI Information

NPI: 1184914046
Provider Name: BEAU YUN PARK, M.D.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual
Organization: JEFFERSON UNIVERSITY PHYSICIANS

PECOS Registration: Yes

Address:
833 CHESTNUT STREET
1ST FLOOR
PHILADELPHIA, PA
ZIP 19107
Phone: (215) 955-5000
Get Directions

Beau Yun Park, M.D. is an obstetrics gynecology in Philadelphia, PA with 13 years of experience. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Beau Yun Park, M.D. NPI is 1184914046. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: CHICAGO COLLEGE OF MEDICINE AND SURGERY
Graduation Year:2011

The provider's business location address is:

833 CHESTNUT STREET
1ST FLOOR
PHILADELPHIA, PA
ZIP 19107
Phone: (215) 955-5000
Fax: (215) 923-1089

The NPI 1184914046 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 4/12/2011 and was last updated on 12/15/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyMD461241PENNSYLVANIAYes
2390200000XStudent in an Organized Health Care Education/Training ProgramNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11033491940001MEDICAIDPENNSYLVANIA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.