Lisa Park, is a medicare enrolled "Colon & Rectal Surgery" physician in Larkspur, California. Her current practice location is
5 Bon Air Rd Ste 101, Larkspur, California. You can reach out to her office (for appointments etc.) via phone at
(415) 924-2515.
Lisa Park is licensed to practice in California (license number A168789) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1568857142.
Physician's Profile
Full Name | Lisa Park |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 5 Bon Air Rd Ste 101, Larkspur, California |
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Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Lisa Park attended and graduated from in
NPI Data:
- NPI Number: 1568857142
- Provider Enumeration Date: 04/01/2015
- Last Update Date: 12/03/2021
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Lisa Park such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1568857142 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 57.027085 (Ohio) | Secondary |
208C00000X | Colon & Rectal Surgery | A168789 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Park is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lisa Park, 5 Bon Air Rd Ste 101, Larkspur, CA 94939-1134 Ph: (415) 924-2515 | Lisa Park, 5 Bon Air Rd Ste 101, Larkspur, CA 94939-1134 Ph: (415) 924-2515 |
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