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

Lisa Park

Individual provider Surgery Physician · NPI 1568857142

Lisa Park is a Colorectal Surgery (Proctology) in Larkspur, California. Graduated from Albany Medical College of Union University in 2015, 11 years ago. Practices with Regents Univ of California UCSF, a 272-clinician group and offers telehealth. Licensed in California and Ohio.

Years since qualifying
11
Trained at
Albany Medical College of Union University
Licensed in
CA, OH
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

5 Bon Air Rd Ste 101
Larkspur, CA 94939-1134
Phone: (415) 924-2515
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Colon & Rectal Surgery Physician (primary) Taxonomy 208C00000X · Licence A168789 (CA)
Surgery Physician Taxonomy 208600000X · Licence 57.027085 (OH)

Record details

NPI number1568857142
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 1, 2015
Last updated in NPPESDecember 3, 2021
Certification dateDecember 3, 2021
Mailing address5 Bon Air Rd Ste 101, Larkspur, CA 94939-1134

Medicare enrollment

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

Medicare specialtyCOLORECTAL SURGERY (PROCTOLOGY)
Medical schoolALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduated 2015 (11 years in practice)
Group practice Regents Univ Of California Ucsf — 272 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

Other providers in Larkspur