DR. PAUL J PARK (NPI# 1386765105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386765105 |
| Entity Type | Individual |
| Full Name | DR. PAUL J PARK |
| Credential | MD |
| Practice Address |
1155 Mill St # W11 Reno NV 89502-1576 |
| Practice Telephone | 7753275174 |
| Practice Fax Number | 8882348328 |
| Mailing Telephone | 7753275174 |
| Mailing Fax Number | 8882348328 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2017-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 7942612-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 7942612-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 49828 | MN | Allopathic & Osteopathic Physicians |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 381602000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
| 1316180037 | Paul Park | Internal Medicine | Box 3951 Or Trent Drive - Dumc, Gme Office, Rm 139-green Zone, Durham, NC 27710 | 2009-04-10 |
| 1083670152 | Paul W. Park | Ophthalmology | 4278 W 3rd St, Los Angeles, CA 90020-3449 | 2006-04-26 |
| 1801434360 | Paul Park IIi | Physical Therapist | 400 Parnassus Ave, San Francisco, CA 94143-2202 | 2019-12-16 |
| 1306491261 | Paul J Park | Dentist | 3145 Garden Ave, Building 1278, San Antonio, TX 78234 | 2019-08-07 |
| 1629537964 | Paul Park | Student in an Organized Health Care Education/Training Program | 22 S Greene St # S11c, Baltimore, MD 21201-1544 | 2019-03-17 |
| 1508339094 | Paul Park | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2019-01-07 |
| 1932616034 | Paul Park | Marriage & Family Therapist | 6301 Beach Blvd Ste 245, Buena Park, CA 90621-4031 | 2018-01-10 |
| 1386195980 | Paul Park | Acupuncturist | 6954 Vaughn Rd, Montgomery, AL 36116-1368 | 2016-10-18 |
| 1679927206 | Paul Park | Internal Medicine | 2925 Chicago Ave, Minneapolis, MN 55407-1321 | 2016-04-20 |
| Street Address |
1155 MILL ST # W11 |
| City | RENO |
| State | NV |
| Zip Code | 89502-1576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003844127 | Charles Gilbert Childers | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2006-06-29 |
| 1043834625 | Amr Alkasir | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-05-30 |
| 1730709130 | Liron Gokovski | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-04-26 |
| 1740809581 | Fahd Hussain | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-04-12 |
| 1902435704 | Ramamahesh Seeni | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-04-03 |
| 1720617574 | Yo Sup Keum | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-04-03 |
| 1205465259 | Adam Weilum Tsen | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-04-02 |
| 1174152110 | Sachin Sreenivasan | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-04-02 |
| 1740819671 | George Velasco | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-04-02 |
| 1457980500 | Ishan Sunil Naik | Student in an Organized Health Care Education/Training Program | 1155 Mill St # W11, Reno, NV 89502-1576 | 2020-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
| 1447879259 | Ryan Johnson | Student in an Organized Health Care Education/Training Program | 1155 Mill St. W-11, Reno, NV 89502 | 2020-04-11 |
| 1396378063 | Domingko Loney | Chore Provider | 1325 Air Motive Wat St 262, Reno, NV 89502 | 2020-02-20 |
| 1053954842 | Derek Craig | Home Health Aide | 1000 Havard Way #29, Reno, NV 89502 | 2019-10-24 |
| 1477108124 | Marisa Rachael Traversie | Nurse Practitioner | 910 Vista Boulevard, Sparks, NV 89502 | 2019-08-08 |
| 1912564675 | Patrick Llewellyn Merrill | Social Worker | 975 Kirman Ave - Ch 116, Reno, NV 89502 | 2019-05-28 |
| 1881154706 | Naresh Kumar Veerabattini | Student in an Organized Health Care Education/Training Program | 1155 Mill St, Renown Regional Medical Center, W11 Academic Department Offices, Reno, NV 89502 | 2019-03-25 |
| 1053899187 | Daphne London | Behavioral Analyst | 1325 Airmotive Way Ste 260, Reno, NV 89502 | 2018-07-31 |
| 1790271609 | Jennifer J Padolina | Optometrist | 2296 Kietzke Ln, Reno, NV 89502 | 2018-07-03 |
| 1336630185 | Lindsey Cherie Cooper | Technician | 3563 Sol Grande Ct, Reno, NV 89502 | 2018-05-27 |
| Find all providers in zip 89502 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949840 | Mekha Omarimuhammad | Student in an Organized Health Care Education/Training Program | 2505 Rio Rico Ct, Reno, NV 89523-6213 | 2020-07-08 |
| 1912529744 | Michelle Loubet | Student in an Organized Health Care Education/Training Program | 18600 Wedge Pkwy Ste 104, Reno, NV 89511-3036 | 2020-05-14 |
| 1902428915 | Roxann Jeanette Richardson | Student in an Organized Health Care Education/Training Program | Unr Redfield Campus Nell J. Redfield Bldg. A, Suite 104 18600 Wedge Parkway, Reno, NV 89511 | 2020-05-13 |
| 1447879259 | Ryan Johnson | Student in an Organized Health Care Education/Training Program | 1155 Mill St. W-11, Reno, NV 89502 | 2020-04-11 |
| 1710516620 | Gianni Boitano Perano | Student in an Organized Health Care Education/Training Program | 1664 N Virginia Street Brigham Building/316, Reno, NV 89557-0001 | 2020-04-02 |
| 1699303750 | Loren Fisher | Student in an Organized Health Care Education/Training Program | 1664 N Virginia Street Brigham Bldg 316, Reno, NV 89557-0169 | 2020-04-01 |
| 1821626698 | Haviva Kobany | Student in an Organized Health Care Education/Training Program | 3465 Ridgecrest Dr, Reno, NV 89512-1443 | 2020-03-29 |
| 1508493800 | Martin Azzam | Student in an Organized Health Care Education/Training Program | 4210 Amber Marie Ln, Reno, NV 89503-1022 | 2020-03-25 |
| 1003441197 | Marisa Ann Sewell | Student in an Organized Health Care Education/Training Program | 1664 N Virginia Ave Unr School of Medicine, Reno, NV 89557-0001 | 2020-03-09 |
| 1104478411 | Taryn Bales | Student in an Organized Health Care Education/Training Program | 6340 Antero Dr, Reno, NV 89523-2845 | 2019-07-16 |
| Find all providers in RENO | ||||
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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.