BRUCE PARK, M.D. A PROFESSIONAL CORPORATION
NPI 1851478358
Dermatology in Fullerton, CA

Active since November 01, 2006
1966 E CHAPMAN AVE, SUITE G, FULLERTON, CA 92831(714) 525-0545 Get Directions Write a Review

NPPES record last updated: June 5, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Bruce Park, M.d. A Professional Corporation NPPES

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

BRUCE PARK, M.D. A PROFESSIONAL CORPORATION (NPI 1851478358), doing business as Bruce Park Md, is a healthcare organization registered as a dermatology in Fullerton, California and active in the NPI registry since November 2006. The organization lists Bruce S Park, Ceo, as its authorized official.

NPPES Registry Identity

NPI1851478358
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBRUCE PARK, M.D. A PROFESSIONAL CORPORATION
Location Address1966 E CHAPMAN AVE, SUITE GFullerton, CA 92831-4142
Mailing Address1966 E Chapman Ave, Suite GFullerton, CA 92831-4142 · (714) 562-0542
Organization SubpartNo
Authorized OfficialBruce S ParkCeo · (714) 525-0545
Enumeration DateNovember 1, 2006
Last NPPES UpdateJune 5, 2014
✔ NPI 1851478358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1966 E CHAPMAN AVE, Fullerton, CA 92831

Other Names 1

Former Legal Business NameBruce Park Md

Other Identifiers 3

Medicare PINZZZ05140Z
Medicare PINW20541
Medicare PINW20541A

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bruce Park, M.d. A Professional Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bruce Park, M.D. A Professional Corporation, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1841378825
1966 E CHAPMAN AVE STE G
Fullerton, CA 92831
(714) 525-0545
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Bruce Park, M.D. A Professional Corporation's NPI number?

The NPI number for Bruce Park, M.D. A Professional Corporation is 1851478358. It was assigned to this organization in the NPPES registry on November 1, 2006. The provider was formerly known as Bruce Park MD.

Where is Bruce Park, M.D. A Professional Corporation located?

Bruce Park, M.D. A Professional Corporation is located at 1966 E Chapman Ave Suite G, Fullerton, CA 92831. The listed phone number is (714) 525-0545.

What is Bruce Park, M.D. A Professional Corporation's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Bruce Park, M.D. A Professional Corporation enrolled in Medicare?

Yes. Bruce Park, M.D. A Professional Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bruce Park, M.D. A Professional Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Bruce Park, M.D. A Professional Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bruce Park, M.D. A Professional Corporation was last updated on June 5, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.