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

Ji Yeon Park, DO

Individual provider Internal Medicine Physician · NPI 1295189850

Ji Yeon Park, DO is an Internal Medicine in Colton, California. Qualified in 2016, 10 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
10
Licensed in
CA
In the registry since
2016
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

400 N Pepper Ave
Colton, CA 92324-1801
Phone: (909) 580-6266
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1100 W Stewart Dr, Orange, CA 92868-3849 — (714) 628-3136

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 20A16572 (CA)

Record details

NPI number1295189850
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 20, 2016
Last updated in NPPESDecember 10, 2021
Certification dateDecember 10, 2021
Mailing address400 N Pepper Ave, Colton, CA 92324-1801

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Colton