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

Kimberly Park, MD

Individual provider Emergency Medicine Physician · NPI 1124760814

Kimberly Park, MD is an Emergency Medicine in Loma Linda, California. Qualified in 2018, 8 years ago. Practices with Faculty Physicians and Surgeons of Llusm, a 1,308-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2022
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

11234 Anderson St
Loma Linda, CA 92354-2804
Phone: (909) 558-4085
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence A191049 (CA)

Record details

NPI number1124760814
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 12, 2022
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Faculty Physicians And Surgeons Of Llusm — 1308 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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