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

Jeong Ho Park

Individual provider Physical Therapist · NPI 1114654829

Jeong Ho Park is a Physical Therapist in San Leandro, California. Practices as a sole proprietor. Licensed in California and Texas.

Licensed in
CA, TX
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1652 Mono Ave
San Leandro, CA 94578-2020
Phone: (510) 481-3200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 303035 (CA)
Physical Therapist Taxonomy 225100000X · Licence 1329142 (TX)

Record details

NPI number1114654829
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 3, 2022
Last updated in NPPESDecember 7, 2023
Certification dateDecember 6, 2023

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