MEDICARE: J PARK CHIROPRACTIC, P.C.

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1962369132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J PARK CHIROPRACTIC, P.C.

Provider Business Mailing Address
First Line	:	15591 RED HILL AVE.
Second Line	:	STE 100
City	:	TUSTIN
State	:	CA
Zip	:	92780
Country	:	US
Telephone Number	:	949-392-9534
Fax Number	:

Provider Business Practice Location Address
First Line	:	15591 RED HILL AVE.
Second Line	:	STE 100
City	:	TUSTIN
State	:	CA
Zip	:	92780
Country	:	US
Telephone Number	:	949-392-9534
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOE PARK
Credential	:	DC
Telephone Number	:	949-701-8250

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/12/2026

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