DR. BRANDON BIRG PARK (NPI# 1063675171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063675171 |
| Entity Type | Individual |
| Full Name | DR. BRANDON BIRG PARK |
| Credential | M.D. |
| Practice Address |
389 S 900 E Salt Lake Clinic Salt Lake City UT 84102-2310 |
| Practice Telephone | 3852822000 |
| Mailing Telephone | 3852822000 |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2013-11-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
8212530-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487921540 | Brandon Hyungki Park | Physical Therapist | 511 Lincoln St Apt 7, Palisades Park, NJ 07650-2606 | 2011-11-17 |
| 1326504622 | Brandon Juyoung Park | Physical Therapist | 112 Newport Towne Ctr, Newport, TN 37821-7360 | 2019-02-12 |
| 1801112891 | Brandon S Park | Clinical Neuropsychologist | 2100 Napa Vallejo Hwy, Napa, CA 94558-6234 | 2010-04-15 |
| 1811960123 | Brandon D Park | Nurse Practitioner | 5782 Adams Avenue Parkway, Washington Terrace, UT 84405 | 2006-02-08 |
| Street Address |
389 S 900 E SALT LAKE CLINIC |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-2310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205810751 | Rachel Mitchell | Internal Medicine | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2005-11-29 |
| 1992311799 | Hannah Benoit Belles | Physical Therapist | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2020-09-17 |
| 1447876263 | Erin Ashley Romero | Physical Therapist | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2020-06-17 |
| 1972159952 | Paul Jacob Sharp | Nurse Practitioner | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2019-08-14 |
| 1053886655 | Jamie Plimpton | Physician Assistant | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2018-10-10 |
| 1467817270 | Mary K Jefferson | Dietitian, Registered | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2015-12-21 |
| 1316321797 | Laura Cushman | Clinical Exercise Physiologist | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2015-07-15 |
| 1265816193 | Jessica Laroche | Dietitian, Registered | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2015-07-09 |
| 1033598446 | Nira Liat Salant | Physical Therapist | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2015-05-19 |
| 1730571126 | Julie Lynn Roberts | Nurse Practitioner | 389 S 900 E, Salt Lake Clinic, Salt Lake City, UT 84102-2310 | 2015-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296505 | Us Sports Medicine, LLC | Radiology | 1178 E Brickyard Rd, Salt Lake City, UT 84106-2555 | 2019-10-09 |
| 1467865329 | Shane Nicholas Weber | Radiology | 30 N 1900 E Rm 1a07, Salt Lake City, UT 84132-0002 | 2014-06-09 |
| 1508124843 | Nikolas Michael Damme | Radiology | 30 N 1900 East #1a071, Apt B4, Salt Lake City, UT 84413-2140 | 2012-04-24 |
| 1093071045 | Kaerli Main Christensen | Radiology | 30 North 1900 East, Room 4c104, University of Utah Department of Internal Medicine, Salt Lake City, UT 84132 | 2012-04-04 |
| 1952697849 | Ashley D. Gettemy | Radiology | 30 N 1900 E Rm 1a071, Salt Lake City, UT 84132-0002 | 2011-06-20 |
| 1598056848 | Miriam Peckham | Radiology | 30 N 1900 E # 1c412, Gme Office, Salt Lake City, UT 84132-2115 | 2011-04-20 |
| 1285945006 | David Cameron Olson | Radiology | 30 N 1900 E # 1a71, Salt Lake City, UT 84132-0002 | 2010-06-25 |
| 1619292182 | Richard Keller | Radiology | 1235 East 200 South #702, 1235 East 200 South #702, Salt Lake City, UT 84102-8410 | 2010-03-29 |
| 1699914267 | George Nicholas Baldwin | Radiology | 3519 E. Arcata R, Salt Lake City, UT 84124-4738 | 2009-02-05 |
| 1285896415 | Joseph Scott Mcnally | Radiology | 447 Edith Ave, Salt Lake City, UT 84111-4724 | 2008-06-29 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
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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.