JIN HYUK PARK (NPI# 1306824909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306824909 |
| Entity Type | Individual |
| Full Name | JIN HYUK PARK |
| Credential | M.D. |
| Practice Address |
8500 Executive Park Ave Ste 110 Fairfax VA 22031-2228 |
| Mailing Address |
8500 Executive Park Ave Suite 110 Fairfax VA 22031-2225 |
| Practice Telephone | 7035730504 |
| Practice Fax Number | 7035734856 |
| Mailing Telephone | (703) 573-0504 |
| Mailing Fax Number | 7035734856 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2017-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
0101232879 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 006736262 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730619032 | Jin Park | Acupuncturist | 1096 N Western Ave Ste 107, Los Angeles, CA 90029-2340 | 2017-06-19 |
| 1972767069 | Jin Park | Optometrist | 266 Yorktown Ctr, Lombard, IL 60148-5526 | 2008-07-17 |
| 1245440486 | Jin Woo Park | Acupuncturist | 1323 Phillips Dr, Fullerton, CA 92833-5641 | 2007-05-23 |
| 1255548343 | Jin Sook Park | Physical Therapist | 630 Hillcrest Dr, Redwood City, CA 94062 | 2007-05-17 |
| 1336264126 | Jin Won Park | Acupuncturist | 9042 Garden Grove Blvd Ste 299, Garden Grove, CA 92844-1370 | 2007-03-20 |
| 1164552246 | Jin Hwi Park | Dentist | 9295 Magnolia Ave, #103, Riverside, CA 92503-3800 | 2007-03-06 |
| 1992800353 | Jin Hewa Park | Family Medicine | 250 W San Jose Ave, Claremont, CA 91711-5207 | 2006-09-13 |
| 1962436550 | Jin Sup Park | Radiology | 8619 Pasture View Ln, Houston, TX 77024-7039 | 2006-07-10 |
| 1053948034 | Jin Patrick Park | Student in an Organized Health Care Education/Training Program | 505 E 70th St, New York, NY 10021-4872 | 2020-03-27 |
| 1073052478 | Jin Park | Pharmacist | 1900 E Lambert Rd, Brea, CA 92821-4371 | 2017-02-17 |
| Street Address |
8500 EXECUTIVE PARK AVE STE 110 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-2228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750369351 | Alan Eric Benheim | Pediatrics | 8500 Executive Park Ave Ste 110, Fairfax, VA 22031-2228 | 2006-01-04 |
| 1265990212 | Shripriya Mohan O'neill | Nurse Practitioner | 8500 Executive Park Ave Ste 110, Fairfax, VA 22031-2228 | 2019-03-08 |
| 1518018076 | Sarah Ann Chambers Gurson | Pediatrics | 8500 Executive Park Ave Ste 110, Fairfax, VA 22031-2228 | 2007-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750369351 | Alan Eric Benheim | Pediatrics | 8500 Executive Park Ave Ste 110, Fairfax, VA 22031-2228 | 2006-01-04 |
| 1184870685 | Harish Sitaram Rudra | Pediatrics | 8316 Arlington Blvd, Suite 500, Fairfax, VA 22031-5207 | 2008-08-15 |
| 1548427271 | Jennifer Brown O'neil | Pediatrics | 8316 Arlington Blvd, Suite 500, Fairfax, VA 22031-5207 | 2008-05-20 |
| 1528021755 | William C Kirby | Pediatrics | 8318 Arlington Blvd, Suite 250, Fairfax, VA 22031-5218 | 2006-04-10 |
| 1265495428 | Jennifer H Lindsey | Pediatrics | 8318 Arlington Blvd, Suite 250, Fairfax, VA 22031-5218 | 2006-04-10 |
| 1861454472 | Stephen R Shapiro | Pediatrics | 8316 Arlington Blvd, Suite 500, Fairfax, VA 22031-5218 | 2006-04-06 |
| 1700848439 | Radha R Cohen | Pediatrics | 8318 Arlington Blvd, Suite 250, Fairfax, VA 22031-5218 | 2006-04-06 |
| 1487616082 | Patrick F Callahan | Pediatrics | 8318 Arlington Blvd, Suite 250, Fairfax, VA 22031-5218 | 2006-04-06 |
| 1275595910 | James Alan Thompson | Pediatrics | 8318 Arlington Blvd, Suite 250, Fairfax, VA 22031-5218 | 2006-04-06 |
| 1831151067 | Frank Martin Galioto Jr. | Pediatrics | 8318 Arlington Blvd, Suite 250, Fairfax, VA 22031-5218 | 2006-04-04 |
| Find all providers in FAIRFAX | ||||
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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.