SONNY PARK PC (NPI# 1801919980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801919980 |
| Entity Type | Organization |
| Organization Name | SONNY PARK PC |
| Other Organization Name | COLUMBIA PACIFIC MEDICAL SERVICES |
| Practice Address |
2120 Exchange St Ste 200 Astoria OR 97103-3365 |
| Practice Telephone | 5033255360 |
| Practice Fax Number | 5033259373 |
| Mailing Telephone | 5033255360 |
| Mailing Fax Number | 5033259373 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2012-10-03 |
| Authorized Official Name | DR. SANGKUN (SONNY) PARK (OWNER) |
| Authorized Official Telephone | 5033255360 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 207R00000X | Internal Medicine | MD18585 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 286976 | 05 | |
| OR | REGENCE GROUP NUMBER | 091424000 | 01 |
| Other Name | Type Code |
|---|---|
| Columbia Pacific Medical Services | Doing Business As Name - Organization |
| Street Address |
2120 EXCHANGE ST STE 200 |
| City | ASTORIA |
| State | OR |
| Zip Code | 97103-3365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275515181 | Stacey Ann Agee | Nurse Practitioner | 2120 Exchange St, Suite 200, Astoria, OR 97103-3365 | 2005-11-16 |
| 1235595760 | Evergreen Prosthetics and Orthotics, LLC | Durable Medical Equipment & Medical Supplies | 2120 Exchange St, Suite 204, Astoria, OR 97103-3365 | 2016-01-13 |
| 1609243641 | Debra Kumm | Pharmacist | 2120 Exchange St, Suite 101, Astoria, OR 97103-3365 | 2015-08-25 |
| 1770975245 | Douglas Merle Garner | Case Manager/Care Coordinator | 2120 Exchange St, Astoria, OR 97103-3365 | 2015-02-20 |
| 1255720850 | Megan Stallter | Counselor | 2120 Exchange St, Astoria, OR 97103-3365 | 2015-01-20 |
| 1871997353 | Bonnie Charlotte Singman | Counselor | 2120 Exchange St, Ste. 301, Astoria, OR 97103-3365 | 2014-10-13 |
| 1790185734 | Jessica K Lawrence | Physical Therapy Assistant | 2120 Exchange St, Suite 104, Astoria, OR 97103-3366 | 2014-08-27 |
| 1568875193 | Laurel Payne | Psychiatry & Neurology | 2120 Exchange St, Astoria, OR 97103-3365 | 2014-06-11 |
| 1700204658 | Nick Benas | Rehabilitation Practitioner | 2120 Exchange St, Suite 301, Astoria, OR 97103-3365 | 2014-03-28 |
| 1215367685 | Ladessa Marie Christensen | Nurse Practitioner | 2120 Exchange St, Suite 202, Astoria, OR 97103-3365 | 2013-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730552845 | Kpg Oregon, LLC | Internal Medicine | 486 12th Street #200, Astoria, OR 97103 | 2015-11-11 |
| 1205239043 | Brittany Dawn Vigoren | Dental Hygienist | 433 30th St., Astoria, OR 97103 | 2014-10-08 |
| 1497188858 | Jennifer U Boggs | Counselor | 10 Pier 1 Ste 203, Astoria, OR 97103 | 2013-08-20 |
| 1780022046 | Judy J Curnow | Massage Therapist | 1 12th Street Suite 10, Astoria, OR 97103 | 2013-06-10 |
| 1659626612 | Megan Lampson | Physical Therapist | 646 16th Ave., Astoria, OR 97103 | 2012-07-16 |
| 1043580947 | Matthew Thomas Cassity | Physical Therapy Assistant | 646 16th St., Astoria, OR 97103 | 2012-01-09 |
| 1881975969 | Rebecca Nicole Roe | Contractor | 25 Whitebush Way, Astoria, OR 97103 | 2011-09-02 |
| 1346542214 | Michele Lynn Hart | Social Worker | 2120 Exchange, Astoria, OR 97103 | 2010-11-29 |
| 1447551197 | Barbara Ellen Arnold | Pharmacist | 3250 Leif Erickson Dr, Astoria, OR 97103 | 2010-11-11 |
| 1083915219 | Christina Louise Jones | Pharmacist | 3250 Lief Erickson Dr, Astoria, OR 97103 | 2010-11-04 |
| Find all providers in zip 97103 | ||||
| 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 |
|---|---|---|---|---|
| 1639526858 | Emili Llazo | Internal Medicine | 2369 24th St # 2f, Astoria, NY 11105-3414 | 2016-05-17 |
| 1740619055 | Timothy Michael Becker | Internal Medicine | 2095 Exchange St Ste 301, Astoria, OR 97103-3400 | 2013-11-06 |
| 1891005922 | Irida Balili | Internal Medicine | 2311 33rd St, 2a, Astoria, NY 11105-2460 | 2010-10-07 |
| 1508198045 | Better Care, Inc | Internal Medicine | 25-92 Steinway Street, Astoria, NY 11103 | 2010-02-09 |
| 1659515302 | Melvina Patel | Internal Medicine | 4101 30th Ave, Astoria, NY 11103-2908 | 2009-04-25 |
| 1619110277 | Abdul Ali Khuwaja.physician PC | Internal Medicine | 45 05 Broadway, Astoria, NY 11103-1625 | 2009-04-13 |
| 1407094410 | Socrates Thomas Kangadis | Internal Medicine | 2309 31st St, Unit # 3, Astoria, NY 11105-2767 | 2009-01-29 |
| 1194978403 | Amita Toprani | Internal Medicine | 2407 19th St Apt 2r, Astoria, NY 11102-3442 | 2008-10-30 |
| 1124282694 | Ken Truong | Internal Medicine | 2322 Broadway, Astoria, NY 11106-4196 | 2008-07-15 |
| 1154583227 | Rita Shah | Internal Medicine | 3011 21st St Apt 5d, Astoria, NY 11102-2873 | 2008-06-30 |
| Find all providers in ASTORIA | ||||
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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.