Joe Park (NPI# 1083645832, PAC ID# 4688643604) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ANESTHESIOLOGY.
| Nation Provider ID (NPI) | 1083645832 |
| PAC ID by PECOS | 4688643604 |
| Professional Enrollment ID | I20040927001172 |
| Full Name | Joe Park |
| Address |
15447 W Sand St Advanced Pain Management Center Victorville CA 92392-2904 |
| Gender | M |
| Credential | MD |
| Medical School | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | ANESTHESIOLOGY |
| Secondary Specialties | INTERVENTIONAL PAIN MANAGEMENT |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050300 | ST MARY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 15447 W Sand St, Advanced Pain Management Center, Victorville, CA 92392-2904 |
| Street Address |
15447 W SAND ST ADVANCED PAIN MANAGEMENT CENTER |
| City | VICTORVILLE |
| State | CA |
| Zip | 92392-2904 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bhavleen Jolly | Optometry | 14349 Amargosa Rd, Victorville, CA 92392-2317 | |
| Denton Wells | Optometry | Eyecee Optometric Inc | 14349 Amargosa Rd, Victorville, CA 92392-2317 |
| Warren Newton | Optometry | Drs Wells and Newton | 14349 Amargosa Rd, Victorville, CA 92392-2317 |
| Sara L Griffin | Chiropractic | 14156 Amargosa Rd, Suite G, Victorville, CA 92392-2417 | |
| Judith E Turian | Psychologist, Clinical | 15367 Bonanza Rd, Suite A, Victorville, CA 92392-2469 | |
| Jane G Jackson | Psychologist, Clinical | 14344 Cajon Ave, Victorville, CA 92392-4300 | |
| Ikechukwu A Ohiaeri | Psychiatry | Foothill Behavioral Health Consultants Inc | 14344 Cajon Ave, Suite 102, Victorville, CA 92392-4301 |
| Michael Thomas Hickey | Podiatry | California Foot and Ankle Institute, A Podiatry Corporation | 14400 Bear Valley Rd, Victorville, CA 92392-5406 |
| Nualhathai Songsanand | Ophthalmology | Pacific Eye Institute A Medical Group Inc | 12250 B Amargosa Rd, Victorville, CA 92392-5473 |
| Opeyemi M Oladele | Neurology | High Desert Nephrology Medical Association | 12675 Hesperia Rd, Victorville, CA 92392-5878 |
| Find all physicians in zip 92392 | |||
| City | VICTORVILLE |
| Zip Code | 92392 |
| Specialty | ANESTHESIOLOGY |
| City + Specialty | VICTORVILLE + ANESTHESIOLOGY |
Please comment or provide details below to improve the information on Joe 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.