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

Dr. Samuel Park, MD

Individual provider Family Medicine Physician · NPI 1750532610

Dr. Samuel Park, MD is a Family Practice in Glendale, California. Graduated from University of California, Geffen School of Medicine in 2008, 18 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Trained at
University of California, Geffen School of Medicine
Licensed in
CA
In the registry since
2008
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

444 W Glenoaks Blvd
Glendale, CA 91202-2917
Phone: (818) 552-3000
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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 A111437 (CA)

Record details

NPI number1750532610
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 8, 2008
Last updated in NPPESDecember 3, 2021
Certification dateApril 8, 2020
Mailing address444 W Glenoaks Blvd, Glendale, CA 91202-2917

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduated 2008 (18 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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