Physician Compare National (NPI:1952540908)

HEALTHCARE PROVIDER: JUN KYU PARK M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1952540908
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9436201951
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090715000035
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PARK
	Individual professional last name
Provider First Name	JUN
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	ANESTHESIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5400 BALBOA BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 111
	Group Practice or individual's line 2 address
City	ENCINO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	913165206
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050481
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WEST HILLS HOSPITAL & MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y