Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Caroline Park

Individual provider Physician Assistant · NPI 1669301610

Caroline Park is a Physician Assistant in Los Angeles, California. Qualified in 2025, 1 year ago. Practices with St John's Community Health, a 148-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2026
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Practice location Address checks out

808 W 58th St
Los Angeles, CA 90037-3632
Phone: (323) 541-1411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 67963 (CA)

Record details

NPI number1669301610
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedMay 15, 2026
Last updated in NPPESMay 19, 2026
Certification dateMay 19, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice St. John'S Community Health — 148 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Los Angeles