MEDICARE: DR. ARICK CHARLES PARK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	A202037	CA
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	2019012322	MO
3	207R00000X	Internal Medicine Physician	2019012322	MO
4	207RC0000X	Cardiovascular Disease Physician	A202037	CA
5	207RC0000X	Cardiovascular Disease Physician	2019012322	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184157323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARICK CHARLES PARK MD

Provider Business Mailing Address
First Line	:	1450 TREAT BLVD STE 300
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94597-2168
Country	:	US
Telephone Number	:	925-952-2855
Fax Number	:	314-454-8855

Provider Business Practice Location Address
First Line	:	400 PARNASSUS AVE STE 501
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-2202
Country	:	US
Telephone Number	:	415-353-2873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	03/23/2026

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Directions to “ DR. ARICK CHARLES PARK MD” Practice Location

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