DR. EUN SOO DAVID PARK M.D.
NPI 1407205743
Family Medicine in Tucson, AZ
About Dr. Eun Soo David Park M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. EUN SOO DAVID PARK M.D. (NPI 1407205743) is an individual family medicine provider in Tucson, Arizona, licensed in Michigan (4301116860) and active in the NPI registry since June 2016. He has opted out of Medicare through February 17, 2028 and remains eligible to order and refer and maintains a secondary practice location in Tucson.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Eun Soo David Park M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 17, 2026 through February 17, 2028.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85707 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
DM AFB, AZ 85707
TUCSON, AZ 85707
TUCSON, AZ 85707
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Eun Soo Park's NPI number?
The NPI number for Eun Soo Park is 1407205743. It was assigned to this individual provider in the NPPES registry on June 7, 2016.
Where is Eun Soo Park located?
Eun Soo Park practices at 4175 S Alamo Ave, Tucson, AZ 85707. The listed phone number is (520) 228-2778.
What is Eun Soo Park's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Eun Soo Park enrolled in Medicare?
No. Eun Soo Park has opted out of Medicare through February 17, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Eun Soo Park was last updated on April 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# Dr. Eun Soo David Park, M.D. · NPI 1407205743
Family Medicine physician in Tucson, Arizona. Individual provider, active in the CMS NPPES registry since June 7, 2016.
## Identity
- **NPI:** 1407205743 (Entity type: Individual)
- **Enumerated:** June 7, 2016
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 4301116860 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 4175 S ALAMO AVE, Tucson, AZ 85707-4402
- **Phone:** (520) 228-2778
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through February 17, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** April 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1407205743) · Data from the CMS NPPES public registry.