WILSON H PARK, M.D.,INC. (NPI# 1164639704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164639704 |
| Entity Type | Organization |
| Organization Name | WILSON H PARK, M.D.,INC. |
| Other Organization Name | WILSON H PARK, M.D. |
| Practice Address |
3663 W 6th St Suite 100 Los Angeles CA 90020-3049 |
| Practice Telephone | 2133834000 |
| Practice Fax Number | 2134275588 |
| Mailing Telephone | 2133834000 |
| Mailing Fax Number | 2134275588 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2009-09-17 |
| Authorized Official Name | WILSON HO PARK (PRESIDENT) |
| Authorized Official Telephone | 2133834000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LICENSE NUMBER | G45867 | 01 |
| NPI NUMBER | 1194855627 | 01 |
| Other Name | Type Code |
|---|---|
| WILSON H PARK, M.D. | Other Name - Individual/Organization |
| Street Address |
3663 W 6TH ST SUITE 100 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90020-3049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831129063 | La Town Medical Group, Inc. | Internal Medicine | 3663 W 6th St, Suite 206, Los Angeles, CA 90020-3049 | 2006-07-04 |
| 1700387891 | Young Soon Yang | Nurse Practitioner | 3663 W 6th St, 103, Los Angeles, CA 90020-3047 | 2018-02-23 |
| 1386145712 | Jonah Medical Group Inc | Nurse Practitioner | 3663 W 6th St, 103, Los Angeles, CA 90020-3049 | 2018-02-21 |
| 1407220171 | Sun Rye Lee | Acupuncturist | 3663 W 6th St, #308, Los Angeles, CA 90020 | 2015-11-18 |
| 1881070746 | Hei-paik Kim M D Inc | Clinic/Center | 3663 W 6th St, 203, Los Angeles, CA 90020-3049 | 2015-08-03 |
| 1821406471 | Song Hoe Koo Dds Inc | Clinic/Center | 3663 W 6th St, #204, Los Angeles, CA 90020-3049 | 2014-07-28 |
| 1063853042 | Harry Sukyun Lee | Acupuncturist | 3663 W 6th St, #308, Los Angeles, CA 90020 | 2013-07-08 |
| 1275973968 | Kingsley Pharmacy | Pharmacy | 3663 W 6th St, #102, Los Angeles, CA 90020-3049 | 2013-06-27 |
| 1891072476 | Ardmore Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 3663 W 6th St, Ste108, Los Angeles, CA 90020-3049 | 2011-11-09 |
| 1740577873 | Young H. Kim and Doil Kim Dds Inc | Dentist | 3663 W 6th St, Suite #207, Los Angeles, CA 90020-3049 | 2011-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164948048 | Edwina Antoinette Hunter | Community Health Worker | 550 S. Vermont Ave, 6th Floor, Los Angeles, CA 90020 | 2017-08-22 |
| 1639520661 | Jacqueline Carrasco | Counselor | 550 South Vermont Ave, 10th Floor, Los Angeles, CA 90020 | 2016-06-30 |
| 1649630914 | Hee Seung Lee | Marriage & Family Therapist | 3727 W. 6th Street, Suite 507, Los Angeles, CA 90020 | 2016-03-01 |
| 1134596273 | Jocelyn Marie Lee | Optometrist | 3750 W 6th St Ste 113, Los Angeles, CA 90020 | 2015-08-24 |
| 1316327075 | Lourdes Encarnacion Araujo | Social Worker | 550 S Vermont Ave 3rd Floor, Los Angeles, CA 90020 | 2015-06-08 |
| 1477933463 | Department of Mental Health | Clinic/Center | 550 South Vermont, Los Angeles, CA 90020 | 2015-06-04 |
| 1538566047 | Calvin A. Kim | Internal Medicine | 4220 W 3rd St Ste 201, Los Angeles, CA 90020 | 2014-11-26 |
| 1093115792 | John Abaya | Counselor | 550 S Vermont Ave 10th Floor, Los Angeles, CA 90020 | 2014-08-29 |
| 1528494481 | Sung Eun Lee | Acupuncturist | 340 S New Hampshire Ave #211, Los Angeles, CA 90020 | 2013-09-23 |
| 1861836587 | Robert Lee Smalls Jr. | Marriage & Family Therapist | 550 South Vermont Avenue, Juvenile Justice Transition Aftercare Services Division, Los Angeles, CA 90020 | 2013-04-24 |
| Find all providers in zip 90020 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629680905 | Siavash Arani | Internal Medicine | 4524 San Pedro Pl, Los Angeles, CA 90011-3434 | 2020-08-19 |
| 1306455787 | All Health Medical Group, Inc | Internal Medicine | 1300 N Vermont Ave Ste 1008, Los Angeles, CA 90027-6096 | 2020-07-30 |
| 1912533985 | Milgrom Medical Inc. | Internal Medicine | 1555 Vine St Apt 433s, Los Angeles, CA 90028-5298 | 2020-03-20 |
| 1316582059 | Sera Ramadan, D.o., Inc | Internal Medicine | 1245 Wilshire Blvd Ste 812, Los Angeles, CA 90017-4808 | 2019-11-15 |
| 1154971018 | Del Refugio Healthcare Inc | Internal Medicine | 4800 S Central Ave Ste B, Los Angeles, CA 90011-5459 | 2019-09-12 |
| 1851957245 | Aviva Iofel, M.d., Inc. | Internal Medicine | 6234 Fountain Ave Unit B, Los Angeles, CA 90028-8214 | 2019-05-12 |
| 1588120539 | Netzah Health Corp | Internal Medicine | 866 N Vermont Ave Ste 2, Los Angeles, CA 90029-3587 | 2019-02-14 |
| 1306310495 | Baltimo Medical Center Inc | Internal Medicine | 3700 Wilshire Blvd Ste 422, Los Angeles, CA 90010-2905 | 2019-01-11 |
| 1528531316 | Dauna Marie Health Care Inc | Internal Medicine | 3755 Beverly Blvd Apt 303, Los Angeles, CA 90004-3540 | 2019-01-04 |
| 1710458005 | Equality Health Network PC | Internal Medicine | 555 W 5th St Fl 35, Los Angeles, CA 90013-1010 | 2018-12-11 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90020 |
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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.