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

Dr. Kenneth J Park, DO

Individual provider Obstetrics & Gynecology Physician · NPI 1457643215

Dr. Kenneth J Park, DO is an Obstetrics/Gynecology in Redlands, California. Qualified in 2011, 15 years ago. Practices with Beaver Medical Group P C, a 255-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
15
Licensed in
CA
In the registry since
2011
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.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2 W Fern Ave
Redlands, CA 92373
Phone: (909) 793-3311
Fax: (805) 354-7102
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 14077 (CA)

Record details

NPI number1457643215
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 11, 2011
Last updated in NPPESJuly 31, 2026
Certification dateJuly 31, 2026
Mailing address8077 Florence Ave Ste 112, Downey, CA 90240-3894

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Beaver Medical Group P C — 255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Redlands