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

Edward J Park, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1366795106

Edward J Park, DO is an Urology in Los Alamitos, California. Graduated from College of Osteo Med of the Pacific at Pomona in 2014, 12 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
12
Trained at
College of Osteo Med of the Pacific at Pomona
Licensed in
CA
In the registry since
2012
Specialties on file
2
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.

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Practice location Address checks out

3771 Katella Ave Ste 210
Los Alamitos, CA 90720-3118
Phone: (562) 430-0581
Fax: (562) 598-2110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 200 Mullins Dr, Lebanon, OR 97355-3983 — (541) 259-0200
  • 200 Mullins Dr, Lebanon, OR 97355-3983 — (541) 259-0200

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 20A17227 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1366795106
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedOctober 17, 2012
Last updated in NPPESMay 7, 2024
Mailing address3771 Katella Ave Ste 210, Los Alamitos, CA 90720-3118

Medicare enrollment

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

Medicare specialtyUROLOGY
Medical schoolCOLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Graduated 2014 (12 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Los Alamitos