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DR. SHAWN SEUNG DAE PARK MD
NPI 1538864335
General Practice in Fairfield, CA

Active since April 03, 2023PECOS Enrolled
101 BODIN CIR, FAIRFIELD, CA 94535(707) 423-3792(707) 423-3501 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 13, 2025, Jun 25, 2024, Apr 3, 2023 (3 updates tracked since 2023).

About Dr. Shawn Seung Dae Park Md NPPES

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

DR. SHAWN SEUNG DAE PARK MD (NPI 1538864335) is an individual general practice provider in Fairfield, California, licensed in Indiana (01097499A) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538864335
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. SHAWN SEUNG DAE PARKCredential: MD
Location Address101 BODIN CIRFairfield, CA 94535-1809
Mailing Address101 Bodin CirFairfield, CA 94535-1809 · (707) 423-3792 · Fax (707) 423-3501
Phone(707) 423-3792
Fax(707) 423-3501
Sole ProprietorNo
Enumeration DateApril 3, 2023
Last NPPES UpdateAugust 13, 20253 updates tracked since enumeration
NPPES CertifiedAugust 13, 2025
✔ NPI 1538864335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in IN · 01097499A
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedMilitary Health Care ProviderTaxonomy 171000000X
101 BODIN CIR, Fairfield, CA 94535
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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)

Dr. Shawn Seung Dae Park Md 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.

EDWARD SEAN RODRIGUEZ I.D.M.T
Military Health Care Provider (Independent Duty Medical Technicians)
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-5478
KENDRA MONICA HILL PT
Physical Therapist
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-3000
TIMOTHY GUENTHER MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-3000
ANGELA GIESE MD
Surgery (Vascular Surgery)
101 BODIN CIR
FAIRFIELD, CA 94535
Solano County (707) 423-3000
DR. JOSCELYN D. A. C. AQUININGOC PHARMD
Pharmacist
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (626) 297-8649
DR. ARTHUR JOSEPH MESTAS MD
Family Medicine
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-7295
CATHERINE CELINE BRANSTETTER
Dentist (General Practice)
101 BODIN CIR
TRAVIS AFB, CA 94535
Solano County (707) 423-7085
MEGAN ELIZABETH LEE MD
Student in an Organized Health Care Education/Training Program
101 BODIN CIR
FAIRFIELD, CA 94535
Solano County (707) 423-3000

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 Shawn Park's NPI number?

The NPI number for Shawn Park is 1538864335. It was assigned to this individual provider in the NPPES registry on April 3, 2023.

Where is Shawn Park located?

Shawn Park practices at 101 Bodin Cir, Fairfield, CA 94535. The listed phone number is (707) 423-3792.

What is Shawn Park's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Shawn Park enrolled in Medicare?

Yes. Shawn Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shawn Park was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.