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

John Park

Individual provider Family Medicine Physician · NPI 1417503830

John Park is a Family Practice in Santa Clara, California. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2019, 7 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
7
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
PA
In the registry since
2019
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Practice location Address checks out

710 Lawrence Expy
Santa Clara, CA 95051-5173
Phone: (781) 879-9774
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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 OT019677 (PA)

Record details

NPI number1417503830
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 12, 2019
Last updated in NPPESJanuary 11, 2024
Certification dateJanuary 11, 2024

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2019 (7 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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