Ji Ah Park, is a medicare enrolled "Family Medicine" in Long Beach, California. Her current practice location is
3325 Palo Verde Ave Ste 105, Long Beach, California. You can reach out to her office (for appointments etc.) via phone at
(562) 434-7777.
Ji Ah Park is licensed to practice in California (license number PA58548) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1336703941.
Provider's Profile
Full Name | Ji Ah Park |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 3325 Palo Verde Ave Ste 105, Long Beach, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1336703941
- Provider Enumeration Date: 04/29/2019
- Last Update Date: 07/18/2024
Medicare PECOS Information:
- PECOS PAC ID: 0648672907
- Enrollment ID: I20210708002011
Medical Identifiers
Medical identifiers for Ji Ah Park such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1336703941 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | PA58548 (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. Ji Ah 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 |
Ji Ah Park, 3325 Palo Verde Ave Ste 105, Long Beach, CA 90808-4132 Ph: () - | Ji Ah Park, 3325 Palo Verde Ave Ste 105, Long Beach, CA 90808-4132 Ph: (562) 434-7777 |
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