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

Dr. Grace Jiyoung Park, DO, MPH

Individual provider Family Medicine Physician · NPI 1164677464

Dr. Grace Jiyoung Park, DO, MPH is a Family Practice in Gardena, California. Qualified in 2007, 19 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
19
Licensed in
CA
In the registry since
2008
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.
MPH — Master of Public Health
A graduate degree in population health.

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Practice location Address checks out

15446 S Western Ave Southern California Permanente Medical Group
Gardena, CA 90249-4319
Phone: (310) 965-4821
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 20A10562 (CA)

Record details

NPI number1164677464
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO , MPH
Sole proprietorNo
NPI enumeratedDecember 1, 2008
Last updated in NPPESDecember 6, 2021
Mailing address15446 S Western Ave, Southern California Permanente Medical Group, Gardena, CA 90249-4319

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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