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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. JONGSOOK SUSIE PARK MD
NPI 1821052630
Obstetrics & Gynecology - Gynecology in Garden Grove, CA

Active since April 17, 2006
12665 GARDEN GROVE BLVD #505, GARDEN GROVE, CA 92843(714) 534-2110(714) 534-1155 Get Directions Write a Review

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

About Dr. Jongsook Susie Park Md NPPES

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

DR. JONGSOOK SUSIE PARK MD (NPI 1821052630) is an individual gynecology provider in Garden Grove, California, licensed in California (C41515) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1821052630
Entity TypeIndividualFemale
Primary Taxonomy207VG0400X
Provider Legal NameDR. JONGSOOK SUSIE PARKCredential: MD
Location Address12665 GARDEN GROVE BLVD #505Garden Grove, CA 92843
Mailing Address12665 Garden Grove Blvd #505Garden Grove, CA 92843 · (714) 534-2110 · Fax (714) 534-1155
Phone(714) 534-2110
Fax(714) 534-1155
Sole ProprietorNo
Enumeration DateApril 17, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1821052630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207VG0400X
License✔ Licensed in CA · C41515
Definition
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

Other Identifiers 1

Medicaid00C415150CA

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 Jongsook Park's NPI number?

The NPI number for Jongsook Park is 1821052630. It was assigned to this individual provider in the NPPES registry on April 17, 2006.

Where is Jongsook Park located?

Jongsook Park practices at 12665 Garden Grove Blvd #505, Garden Grove, CA 92843. The listed phone number is (714) 534-2110.

What is Jongsook Park's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

When was this NPI record last updated?

The NPPES record for Jongsook Park was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.