Dr Robert Phil Park, PSYD in Stockton, CA - Medicare Psychologist Provider

Dr Robert Phil Park, PSYD is a medicare enrolled "Psychologist" provider in Stockton, California. His current practice location is 1305 Tommydon St, Stockton, California. You can reach out to his office (for appointments etc.) via phone at (209) 476-5211.

Dr Robert Phil Park is licensed to practice in California (license number PSY20153) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1053472605.

Contact Information

	Dr Robert Phil Park, PSYD
	1305 Tommydon St, Stockton, CA 95210-3364
	(209) 476-5211
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Robert Phil Park
Gender	Male
Speciality	Psychologist
Location	1305 Tommydon St, Stockton, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053472605
Provider Enumeration Date: 12/13/2006
Last Update Date: 01/03/2022

Medicare PECOS Information:

PECOS PAC ID: 4486897972
Enrollment ID: I20130903000131

Medical Identifiers

Medical identifiers for Dr Robert Phil Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053472605	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	PSY20153 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Robert Phil Park allows following entities to bill medicare on his behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Dr Robert Phil 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
Dr Robert Phil Park, PSYD 1305 Tommydon St, Stockton, CA 95210-3364 Ph: (209) 476-5211	Dr Robert Phil Park, PSYD 1305 Tommydon St, Stockton, CA 95210-3364 Ph: (209) 476-5211

Reviews and Comments

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Dr Robert Phil Park, PSYD - Medicare Psychologist in Stockton, CA