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

Connie Jung Park, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1689816621

Connie Jung Park, MD is an Infectious Disease in San Leandro, California. Graduated from University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb) in 2009, 17 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
17
Trained at
University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb)
Licensed in
CA
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2500 Merced St
San Leandro, CA 94577-4201
Phone: (510) 454-2700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3411 Wayne Ave Fl 4h, Bronx, NY 10467-2535 — (718) 920-5438

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X · Licence A157152 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1689816621
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 6, 2009
Last updated in NPPESAugust 5, 2024
Certification dateAugust 5, 2024

Medicare enrollment

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

Medicare specialtyINFECTIOUS DISEASE
Also practisesINTERNAL MEDICINE
Medical schoolUNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated 2009 (17 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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