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

Ji Ah Park

Individual provider Physician Assistant · NPI 1336703941

Ji Ah Park is a Physician Assistant in Long Beach, California. Qualified in 2020, 6 years ago. Practices with Prohealth Partners, a Medical Group, a 234-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2019
Specialties on file
3
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Practice location Address checks out

3325 Palo Verde Ave Ste 105
Long Beach, CA 90808-4132
Phone: (562) 434-7777
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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 PA58548 (CA)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1336703941
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 29, 2019
Last updated in NPPESJuly 18, 2024
Certification dateJuly 18, 2024
Mailing address3325 Palo Verde Ave Ste 105, Long Beach, CA 90808-4132

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Prohealth Partners, A Medical Group — 234 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Long Beach