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

Lily Park, DO

Individual provider Internal Medicine Physician · NPI 1124333455

Lily Park, DO is a Dermatology in Modesto, California. Graduated from Touro Un Col of Osteopathic Medicine, Henderson in 2010, 16 years ago. Practices with Regents of the University of California, a 563-clinician group, works from 4 locations, accepts Medicare assignment and offers telehealth. Licensed in California, Michigan and Oregon.

Years since qualifying
16
Trained at
Touro Un Col of Osteopathic Medicine, Henderson
Licensed in
CA, MI, OR
In the registry since
2010
Specialties on file
5
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

600 Coffee Rd
Modesto, CA 95355-4201
Phone: (209) 521-6097
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 600 Coffee Rd, Modesto, CA 95355-4201 — (209) 521-6097
  • 1390 Waverly Dr Se, Albany, OR 97322-6958 — (503) 362-8385
  • 375 Se Norton Ln Ste C, McMinnville, OR 97128-8484 — (503) 362-8385

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 12765 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 20A12765 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 5101018747 (MI)
Internal Medicine Physician Taxonomy 207R00000X · Licence DO184048 (OR)
Hospitalist Physician Taxonomy 208M00000X · Licence 20A12765 (CA)

Record details

NPI number1124333455
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedAugust 11, 2010
Last updated in NPPESAugust 8, 2024
Certification dateAugust 8, 2024
Mailing address3105 Cedar Ravine Rd, Ste 201, Placerville, CA 95667-6561

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolTOURO UN COL OF OSTEOPATHIC MEDICINE, HENDERSON
Graduated 2010 (16 years in practice)
Group practice Regents Of The University Of California — 563 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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