RENEE E PARK M.D., M.P.H.
NPI 1205079910
Otolaryngology - Pediatric Otolaryngology in Fontana, CA

Q: What is Renee Park's NPI number?

The NPI number for Renee Park is 1205079910. It was assigned to this individual provider in the NPPES registry on April 10, 2009.

Q: What is Renee Park's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Pediatric Otolaryngology, with taxonomy code 207YP0228X.

Q: When was this NPI record last updated?

The NPPES record for Renee Park was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 10, 2009PECOS Enrolled

9961 SIERRA AVE, FONTANA, CA 92335(909) 427-5000 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 29, 2021, Aug 23, 2019, Nov 9, 2015 (3 updates tracked since 2015).

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About Renee E Park M.d., M.p.h. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENEE E PARK M.D., M.P.H. (NPI 1205079910) is an individual pediatric otolaryngology provider in Fontana, California, licensed in California (A135401) and active in the NPI registry since April 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205079910

Entity TypeIndividualFemale

Primary Taxonomy207YP0228X

Provider Legal NameRENEE E PARKCredential: M.D., M.P.H.

Location Address9961 SIERRA AVEFontana, CA 92335-6720

Mailing Address9961 Sierra AveFontana, CA 92335-6720 · (877) 608-0044

Phone(909) 427-5000

Sole ProprietorNo

Enumeration DateApril 10, 2009

Last NPPES UpdateNovember 29, 20213 updates tracked since enumeration

✔ NPI 1205079910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Pediatric OtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207YP0228X

Licenses✔ Licensed in CA · A135401✔ Licensed in PA · MD454696

Definition

A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing.

9961 SIERRA AVE, Fontana, CA 92335

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Renee E Park M.d., M.p.h. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHEILA ANN VANALLEN PT

Physical Therapist

9961 SIERRA AVE, BUILDING 3A
FONTANA, CA 92335

San Bernardino County (909) 427-7727

MR. JAMES DAVID KILLEEN III M.D.

Pediatrics

9961 SIERRA AVE, KAISER PERMANENTE FONTANA - PEDIATRICS
FONTANA, CA 92335

San Bernardino County (909) 427-6960

MR. DHIRESH N PATEL RPH

Pharmacist