Edward J Park (NPI# 1366795106, PAC ID# 0042516783) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1366795106 |
| PAC ID by PECOS | 0042516783 |
| Professional Enrollment ID | I20190906002778 |
| Full Name | Edward J Park |
| Organization Legal Name | COAST UROLOGICAL MEDICAL GROUP, INC. |
| Address |
3771 Katella Ave Suite 210 Los Alamitos CA 90720-3118 |
| Phone Number | 5624300581 |
| Gender | M |
| Medical School | COLLEGE OF OSTEO OF THE PACIFIC |
| Graduation Year | 2014 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 7719871490 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050551 | LOS ALAMITOS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3771 Katella Ave, Suite 210, Los Alamitos, CA 90720-3118 | 5624300581 | COAST UROLOGICAL MEDICAL GROUP, INC. |
| Organization Legal Name | COAST UROLOGICAL MEDICAL GROUP, INC. |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Norris | Urology | Coast Urological Medical Group, Inc. | 3771 Katella Ave, Suite 210, Los Alamitos, CA 90720-3118 |
| Alexa Y Chai | Urology | Coast Urological Medical Group, Inc. | 3771 Katella Ave, Suite 210, Los Alamitos, CA 90720-3118 |
| Stephen Hightower | Urology | Coast Urological Medical Group, Inc. | 3771 Katella Ave, Suite 210, Los Alamitos, CA 90720-3118 |
| William Naftel | Urology | Coast Urological Medical Group, Inc. | 3771 Katella Ave, Suite 210, Los Alamitos, CA 90720-3118 |
| Street Address |
3771 KATELLA AVE SUITE 210 |
| City | LOS ALAMITOS |
| State | CA |
| Zip | 90720-3118 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ankit B Patel | Diagnostic Radiology | Los Alamitos Radiology Group, Inc. | 3771 Katella Ave, Suite 100, Los Alamitos, CA 90720-3111 |
| Vincent S Polek | Diagnostic Radiology | Los Alamitos Radiology Group, Inc. | 3771 Katella Ave, Suite 100, Los Alamitos, CA 90720-3111 |
| Michael Norris | Urology | Coast Urological Medical Group, Inc. | 3771 Katella Ave, Suite 210, Los Alamitos, CA 90720-3118 |
| Marcy Lynn Zwelling | Critical Care (intensivists) | 3771 Katella Ave, Suite 108, Los Alamitos, CA 90720-3111 | |
| Cecilia C Chu | Obstetrics/gynecology | 3771 Katella Ave, Suite 205, Los Alamitos, CA 90720-3118 | |
| Alexa Y Chai | Urology | Coast Urological Medical Group, Inc. | 3771 Katella Ave, Suite 210, Los Alamitos, CA 90720-3118 |
| Atefeh Izadi | Podiatry | 3771 Katella Ave, Suite 200, Los Alamitos, CA 90720-3118 | |
| Jeremy Loren Cook | Podiatry | Alamitos Podiatry Group | 3771 Katella Ave, Suite 200, Los Alamitos, CA 90720-3118 |
| Robert Macdonald | Physical Therapy | Sunset Physical Therapy Corporation | 3771 Katella Ave, Suite 200, Los Alamitos, CA 90720-3118 |
| Jhemon H Lee | Diagnostic Radiology | Los Alamitos Radiology Group, Inc. | 3771 Katella Ave, Suite 100, Los Alamitos, CA 90720-3111 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Haniffa M Maznavi | Internal Medicine | 3791 Katella Ave, Suite 101, Los Alamitos, CA 90720-2000 | |
| Sharon Kelly | Psychologist, Clinical | 3791 Katella Ave, Suite 106, Los Alamitos, CA 90720-2000 | |
| Lawrence G Waldrop | Internal Medicine | 3791 Katella Ave, Suite 104, Los Alamitos, CA 90720-2000 | |
| Mauricio J Heilbron Jr. | General Surgery | Prohealth Partners, A Medical Group | 3791 Katella Ave, Suite 107, Los Alamitos, CA 90720-2000 |
| Harold M Lin | Internal Medicine | 3791 Katella Ave, Suite 105, Los Alamitos, CA 90720-2000 | |
| Mark M Chung | Pulmonary Disease | 3791 Katella Ave, Suite 103, Los Alamitos, CA 90720-2000 | |
| Steve C Landis | Chiropractic | 3621 Farquhar Ave, Los Alamitos, CA 90720-2005 | |
| Craig F Hite | Chiropractic | 3621 Farquhar Ave, Los Alamitos, CA 90720-2005 | |
| David L Vannix | General Surgery | Vascular and General Surgery Associates | 3791 Katella Ave, Suite 201, Los Alamitos, CA 90720-2016 |
| Fritz Baumgartner | Thoracic Surgery | Vascular and General Surgery Associates | 3791 Katella Ave, Suite 201, Los Alamitos, CA 90720-2016 |
| Find all physicians in zip 90720 | |||
| City | LOS ALAMITOS |
| Zip Code | 90720 |
| Specialty | UROLOGY |
| City + Specialty | LOS ALAMITOS + UROLOGY |
Please comment or provide details below to improve the information on Edward J Park.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.