SHAUN PARK M.D.
NPI 1780974212
Pediatrics in Loma Linda, CA

Active since April 18, 2011PECOS Enrolled
11175 CAMPUS ST, CP-A1121, LOMA LINDA, CA 92350(909) 558-8142 Get Directions Write a Review

NPPES record last updated: January 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shaun Park M.d. NPPES

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

SHAUN PARK M.D. (NPI 1780974212) is an individual pediatrics provider in Loma Linda, California, licensed in California (A122388) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780974212
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameSHAUN PARKCredential: M.D.
Location Address11175 CAMPUS ST, CP-A1121Loma Linda, CA 92350-1700
Mailing Address54701 File NumberLos Angeles, CA 90074-4701 · (909) 558-3311
Sole ProprietorNo
Enumeration DateApril 18, 2011
Last NPPES UpdateJanuary 13, 2023
NPI 1780974212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License Licensed in CA · A122388
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
11175 CAMPUS ST, Loma Linda, CA 92350

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Shaun Park M.d. 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 92350 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
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.

Surgery (Surgical Critical Care)
11175 CAMPUS ST, RM 21008
LOMA LINDA, CA 92350
Pediatrics (Pediatric Nephrology)
11175 CAMPUS ST
LOMA LINDA, CA 92350
Student in an Organized Health Care Education/Training Program
11175 CAMPUS ST
LOMA LINDA, CA 92350
Surgery (Surgical Oncology)
11175 CAMPUS ST
LOMA LINDA, CA 92350
Physician Assistant
11175 CAMPUS ST
LOMA LINDA, CA 92350
Pediatrics
11175 CAMPUS ST, SUITE 11120
LOMA LINDA, CA 92350
Physician Assistant
11175 CAMPUS ST
LOMA LINDA, CA 92350
Clinic/Center (Dental)
11175 CAMPUS ST
LOMA LINDA, CA 92350

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 Shaun Park's NPI number?

The NPI number for Shaun Park is 1780974212. It was assigned to this individual provider in the NPPES registry on April 18, 2011.

Where is Shaun Park located?

Shaun Park practices at 11175 Campus St Cp-A1121, Loma Linda, CA 92350. The listed phone number is (909) 558-8142.

What is Shaun Park's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Shaun Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Shaun Park was last updated on January 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.