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

Dr. Richard Park, MD

Individual provider General Practice Physician · NPI 1174718134

Dr. Richard Park, MD is an Internal Medicine in Granada Hills, California. Qualified in 2005, 21 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
21
Licensed in
CA
In the registry since
2007
Specialties on file
3
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

10515 Balboa Blvd Ste 325
Granada Hills, CA 91344-6364
Phone: (186) 789-8758
Fax: (747) 200-2589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence A111560 (CA)
General Practice Physician Taxonomy 208D00000X · Licence A111560 (CA)
Hospitalist Physician Taxonomy 208M00000X · Licence A111560 (CA)

Record details

NPI number1174718134
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 12, 2007
Last updated in NPPESFebruary 5, 2024
Certification dateFebruary 5, 2024
Mailing address2709 Rocky Point Ct., Thousand Oaks, CA 91362

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations7 on file with Medicare

Other providers in Granada Hills