| Richard Park M.d., A Professional Corporation | |
|
10515 Balboa Blvd Ste 325 Granada Hills CA 91344-6364 | |
| (818) 678-9875 | |
| (747) 200-2589 |
| Full Name | Richard Park M.d., A Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 10515 Balboa Blvd Ste 325, Granada Hills, California |
| Authorized Official Name and Position | Richard Park (CEO/PHYSICIAN) |
| Authorized Official Contact | 8186789875 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Park M.d., A Professional Corporation 2709 Rocky Point Ct Thousand Oaks CA 91362-4943 Ph: (805) 368-1293 | Richard Park M.d., A Professional Corporation 10515 Balboa Blvd Ste 325 Granada Hills CA 91344-6364 Ph: (818) 678-9875 |
| NPI Number | 1982946323 |
|---|---|
| Provider Enumeration Date | 03/25/2013 |
| Last Update Date | 04/09/2024 |
| Medicare PECOS PAC ID | 2163643966 |
|---|---|
| Medicare Enrollment ID | O20141020002638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982946323 | NPI | - | NPPES |
| Provider Name | Richard Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174718134 PECOS PAC ID: 5698964906 Enrollment ID: I20110118000516 |
Richard Niemeyer, Md, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17709 Chatsworth St, Granada Hills, CA 91344 Phone: 818-363-3121 Fax: 818-366-1728 | |
Lims Valley Medical Center Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10700 Balboa Blvd, Granada Hills, CA 91344 Phone: 818-366-6550 | |
Avanti Home Doctors, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17050 Chatsworth St Ste 253, Granada Hills, CA 91344 Phone: 818-437-5848 | |
Essential Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11735 Andrew Ave, Granada Hills, CA 91344 Phone: 818-669-8432 | |
Gary John Lawson Md A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17447 Chatsworth St, Granada Hills, CA 91344 Phone: 818-360-1858 Fax: 818-360-4979 | |
Vida Mobile Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16750 Index St, Granada Hills, CA 91344 Phone: 818-425-9437 |