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

Jeong Sik Park, MD

Individual provider Specialist · NPI 1528078961

Jeong Sik Park, MD is a Cardiovascular Disease (Cardiology) in Clearlake, California. Qualified in 1988, 38 years ago. Practices with St Helena Hospital, a 86-clinician group, accepts Medicare assignment and offers telehealth. 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

15250 Lakeshore Dr Ste C
Clearlake, CA 95422-8107
Phone: (707) 995-7077
Fax: (707) 995-0904
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence A45408 (CA)

Record details

NPI number1528078961
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 8, 2006
Last updated in NPPESSeptember 20, 2013

Medicare enrollment

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

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice St. Helena Hospital — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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