| Susan Yooshin Park, MD | |
|
8 Calais, Newport Coast, CA 92657-1055 | |
| (952) 595-1100 | |
| (612) 294-4903 |
| Full Name | Susan Yooshin Park |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 24 Years |
| Location | 8 Calais, Newport Coast, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467668772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | A94505 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Beverly Radiology Medical Group Iii | 3476466376 | 307 |
| Entity Name | Beverly Radiology Medical Group Iii |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962457812 PECOS PAC ID: 3476466376 Enrollment ID: O20031106000784 |
| Entity Name | Pronet Imaging Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528099488 PECOS PAC ID: 5890722755 Enrollment ID: O20050721000831 |
| Entity Name | Beverly Radiology Medical Group Iii |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962457812 PECOS PAC ID: 3476466376 Enrollment ID: O20060221000914 |
| Entity Name | San Fernando Valley Interventional Radiology And Imaging Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942350889 PECOS PAC ID: 3476651431 Enrollment ID: O20070614000478 |
| Entity Name | Radnet Medical Imaging - San Francisco |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548345382 PECOS PAC ID: 9830283761 Enrollment ID: O20070921000636 |
| Entity Name | Emeryville Advanced Imaging Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376597930 PECOS PAC ID: 3375637051 Enrollment ID: O20070926000354 |
| Entity Name | Radadvantage A Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376719666 PECOS PAC ID: 2163597899 Enrollment ID: O20090917000455 |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Yooshin Park, MD 11995 Singletree Ln, Suite 500, Eden Prairie, MN 55344-5347 Ph: (952) 595-1301 | Susan Yooshin Park, MD 8 Calais, Newport Coast, CA 92657-1055 Ph: (952) 595-1100 |