DR. EUN SOO DAVID PARK (NPI# 1407205743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407205743 |
| Entity Type | Individual |
| Full Name | DR. EUN SOO DAVID PARK |
| Credential | M.D. |
| Practice Address |
4175 S Alamo Ave Tucson AZ 85707 |
| Mailing Address |
95 Main St Apt 2b Sayreville NJ 08872-1591 |
| Practice Telephone | 5202282778 |
| Mailing Telephone | 2535459791 |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2019-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301116860 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 95 Main St, Apt 2b, Sayreville, NJ 088721591 | 2535459791 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548884034 | Eun Soo Park | Pharmacist | 805 S Val Vista Dr, Gilbert, AZ 85296-3788 | 2020-06-01 |
| Street Address |
4175 S ALAMO AVE |
| City | TUCSON |
| State | AZ |
| Zip Code | 85707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760956387 | Kyle Lynn Craver | Military Health Care Provider | 4175 S Alamo Ave, Tucson, AZ 85707 | 2019-01-16 |
| 1396216099 | Laura Bette | Social Worker | 4175 S Alamo Ave, Tucson, AZ 85707-4402 | 2018-12-07 |
| 1679048250 | Lam T Chung | Pharmacist | 4175 S Alamo Ave, Tucson, AZ 85707-4402 | 2018-10-10 |
| 1811477235 | Alan Thatcher Price | Military Health Care Provider | 4175 S Alamo Ave, Tucson, AZ 85707-4402 | 2018-08-15 |
| 1841776101 | Kimberly Johnson | Nurse Practitioner | 4175 S Alamo Ave, Tucson, AZ 85707-4402 | 2018-07-19 |
| 1457868598 | Kristina Marie Linden | Social Worker | 4175 S Alamo Ave, Tucson, AZ 85707-4402 | 2018-01-10 |
| 1235668054 | Joseph Anthony Everett | Dentist | 4175 S Alamo Ave, Tucson, AZ 85707-4402 | 2017-06-06 |
| 1477907590 | Vanessa F Scheirer | Physical Therapist | 4175 S Alamo Ave, Tucson, AZ 85707-4402 | 2016-04-14 |
| 1164883104 | Marc Enslow | Dentist | 4175 S Alamo Ave, Tucson, AZ 85707-4402 | 2016-03-18 |
| 1043679871 | Meghan Elizabeth Witten | Nurse Practitioner | 4175 S Alamo Ave, Tucson, AZ 85707 | 2016-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699128850 | Megan Dehaven | Specialist/Technologist | 5455 E Comanche St, Tucson, AZ 85707 | 2016-07-22 |
| 1780927954 | Ryan N Taylor | Physician Assistant | 400, 4175 S Alamo Ave, Davis-monthan Afb, AZ 85707 | 2013-04-05 |
| 1154658839 | Alisha A Marchetti | Physician Assistant | 4175 S. Alamo Avenue, 355th Mdg/mdos, Davis-monthan Afb, AZ 85707 | 2009-11-17 |
| 1851529192 | Christopher Thomas Yarbrough | Military Health Care Provider | 4625 South Phoenix Street Bldg 4843, Tucson, AZ 85707 | 2009-06-25 |
| 1144457045 | Denise Fabian | Psychiatry & Neurology | 5427 E. Madera Street, Davis Monthan Afb, AZ 85707 | 2009-06-17 |
| 1942437447 | Emerson M Earle | Military Health Care Provider | 4625 S. Phoenix St, Bld 4843, Tucson, AZ 85707 | 2009-06-11 |
| 1164657136 | Raul Romero | Military Health Care Provider | 4575 S. Phoenix St. 563rd Oss, Dmafb, AZ 85707 | 2009-05-20 |
| 1063647196 | Virginia E. Bailey | Military Health Care Provider | 4837 S Phoenix St., Rm 119 Davis-monthan Air Force Base, Tucson, AZ 85707 | 2009-05-19 |
| 1043417611 | Jacob Riis | Orthopaedic Surgery | 355 Mdg, 4175 South Alamo Ave, Tucson, AZ 85707 | 2007-06-28 |
| 1508989732 | Christopher E. Dunham | Physician Assistant | 4175 S. Alamo Ave Bldg 400, 355th Medical Group-davis Monthan Afb, Tucson, AZ 85707 | 2007-04-10 |
| Find all providers in zip 85707 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609493402 | Old Pueblo Mobile Medicine LLC | Family Medicine | 9721 E Colette St, Tucson, AZ 85748-2756 | 2020-06-29 |
| 1023641792 | Amy Fitzgerald | Family Medicine | 2442 E Blue Diamond Dr, Tucson, AZ 85718-6691 | 2020-02-20 |
| 1578194866 | Keto Consults LLC | Family Medicine | 7469 E Broadway Blvd Ste A, Tucson, AZ 85710-1487 | 2020-01-27 |
| 1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
| 1215440326 | Maryelizabeth Hunter | Family Medicine | 6890 E Sunrise Dr Ste 120-176, Tucson, AZ 85750-0738 | 2017-11-10 |
| 1164963591 | Shohei Sowid-shima | Family Medicine | 6860 E Sunrise Dr Ste 100, Tucson, AZ 85750-0733 | 2017-03-18 |
| 1588024178 | Norma A. Price | Family Medicine | 602 W Ajo Way, Tucson, AZ 85713-6046 | 2016-02-25 |
| 1801279617 | Mitul Vinodkumar Mehta | Family Medicine | 2355 N Wyatt Dr Ste 101, Tucson, AZ 85712-2120 | 2015-06-30 |
| 1649652280 | Angela Suhale Puthenveetil | Family Medicine | 8020 N Cortaro Rd Ste 150, Tucson, AZ 85743-8305 | 2015-06-19 |
| 1366821068 | Renewed Medical Health | Family Medicine | 3382 E Speedway Blvd, Tucson, AZ 85716-3936 | 2015-05-27 |
| Find all providers in TUCSON | ||||
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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.