1. Home
  2. Directory
  3. California
  4. Los Angeles
  5. Physician Assistant
  6. NPI Profile
Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

CAROLINE PARK
NPI 1669301610
Physician Assistant in Los Angeles, CA

Active since May 15, 2026PECOS Enrolled
808 W 58TH ST, LOS ANGELES, CA 90037(323) 541-1411 Get Directions Write a Review

NPPES record added: May 19, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 19, 2026, May 15, 2026 (2 updates tracked since 2026).

About Caroline Park NPPES

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

CAROLINE PARK (NPI 1669301610) is an individual physician assistant in Los Angeles, California, licensed in California (67963) and active in the NPI registry since May 2026. The provider is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669301610
Entity TypeIndividual
Primary Taxonomy363A00000X
Provider Legal NameCAROLINE PARK
Location Address808 W 58TH STLos Angeles, CA 90037-3632
Mailing Address808 W 58th StLos Angeles, CA 90037-3632
Phone(323) 541-1411
Sole ProprietorNo
Enumeration DateMay 15, 2026
Last NPPES UpdateMay 19, 20262 updates tracked since enumeration
NPPES CertifiedMay 19, 2026
✔ NPI 1669301610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 67963
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
808 W 58TH ST, Los Angeles, CA 90037
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Caroline Park 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90037 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

TAMMY SUE TOWNS APRN
Nurse Practitioner (Women's Health)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1400
DAVID K YOO NP
Nurse Practitioner (Family)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1411
GABRIELLA OLOYE RN, FNP
Nurse Practitioner (Family)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1141
KIMI YAMAMOTO
Dentist (Orofacial Pain)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 285-9830
DR. SAGHAR SABER M.D
Internal Medicine (Infectious Disease)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1411
INGEBORG WESTIEN MD
Pediatrics
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1600
KEISHA NERISE CONWRIGHT FNP
Nurse Practitioner (Family)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1600
DR. DEANDRA NICHELLE TURNER D.D.S.
Dentist (Pediatric Dentistry)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1600

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 Caroline Park's NPI number?

The NPI number for Caroline Park is 1669301610. It was assigned to this individual provider in the NPPES registry on May 15, 2026.

Where is Caroline Park located?

Caroline Park practices at 808 W 58th St, Los Angeles, CA 90037. The listed phone number is (323) 541-1411.

What is Caroline Park's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Caroline Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Caroline Park was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.