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

Dr. Haeli Park, MD

Individual provider Pediatrics Physician · NPI 1114422631

Dr. Haeli Park, MD is a Pediatrics Physician in Lodi, California. Licensed in California. Registered with an NPI since 2018.

Licensed in
CA
In the registry since
2018
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone: (209) 339-7639
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence A163831 (CA)

Record details

NPI number1114422631
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 27, 2018
Last updated in NPPESAugust 1, 2021
Certification dateAugust 1, 2021

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