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

Sang Park

Individual provider Physician Assistant · NPI 1992657910

Sang Park is a Physician Assistant in Los Angeles, California. Qualified in 2024, 2 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2026

Practice location Address checks out

590 N Vermont Ave
Los Angeles, CA 90004-2115
Phone: (323) 284-7998
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (CA)

Record details

NPI number1992657910
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorYes
NPI enumeratedFebruary 11, 2026
Last updated in NPPESFebruary 11, 2026
Certification dateFebruary 11, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Los Angeles