Kwanghwi Park, RN is a
Student In An Organized Health Care Education/training Program based in Sacramento, California. Kwanghwi Park is licensed to practice in * (Not Available) (license number ) and his current practice location is
2570 48th St, Sacramento, California. He can be reached at his office (for appointments etc.) via phone at
(916) 734-2145.
NPI number for Kwanghwi Park is 1407659360 and his current mailing address is 15028 Cross Stone Dr, San Diego, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1407659360.
Provider's Profile
| Full Name | Kwanghwi Park |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 2570 48th St, Sacramento, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1407659360
- Provider Enumeration Date: 03/28/2025
- Last Update Date: 04/26/2025
Medical Identifiers
Medical identifiers for Kwanghwi Park such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407659360 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163WC0200X | Registered Nurse - Critical Care Medicine | 95272857 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Kwanghwi Park is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kwanghwi Park, RN
15028 Cross Stone Dr,
San Diego, CA 92127-4423
Ph: (201) 787-1387 | Kwanghwi Park, RN
2570 48th St,
Sacramento, CA 95817-1541
Ph: (916) 734-2145 |
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