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

Dr. Samuel K. Park, MD

Individual provider Family Medicine Physician · NPI 1497832661

Dr. Samuel K. Park, MD is a Family Practice in Newport Beach, California. Qualified in 1988, 38 years ago. Practices with Avera McKennan, a 962-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
38
Licensed in
CA
In the registry since
2006
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

20072 SW Birch St Ste 100
Newport Beach, CA 92660-0794
Phone: (949) 757-1150
Fax: (949) 757-1170
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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 A050474 (CA)

Record details

NPI number1497832661
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedNovember 1, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice Avera McKennan — 962 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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