JENNIFER EUN KYONG PARK MD
NPI 1740817642
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Q: What is Jennifer Park's NPI number?

The NPI number for Jennifer Park is 1740817642. It was assigned to this individual provider in the NPPES registry on March 23, 2020.

Q: What is Jennifer Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Park was last updated on March 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 March 23, 2020PECOS Enrolled

10833 LE CONTE AVE # CHS27139, LOS ANGELES, CA 90095(310) 825-9945 Get Directions Write a Review

NPPES record last updated: March 23, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Jennifer Eun Kyong Park Md NPPES

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

JENNIFER EUN KYONG PARK MD (NPI 1740817642) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740817642

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJENNIFER EUN KYONG PARKCredential: MD

Location Address10833 LE CONTE AVE # CHS27139Los Angeles, CA 90095-3075

Mailing Address10833 Le Conte Ave # Chs27139Los Angeles, CA 90095-3075 · (310) 825-9945

Phone(310) 825-9945

Sole ProprietorNo

Enumeration DateMarch 23, 2020

NPPES CertifiedMarch 23, 2020

✔ NPI 1740817642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

10833 LE CONTE AVE # CHS27139, Los Angeles, CA 90095

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)

Jennifer Eun Kyong 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.

Leave this field empty

Other Providers at the Same Location NPPES 14

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

DR. ELAINE Y L CHAN MD

Student in an Organized Health Care Education/Training Program