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

SE Ra Park

Individual provider Certified Registered Nurse Anesthetist · NPI 1558761395

SE Ra Park is a Certified Registered Nurse Anesthetist (CRNA) in Downey, California. Qualified in 2015, 11 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2014
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Practice location Address checks out

9333 Imperial Hwy
Downey, CA 90242-2812
Phone: (833) 574-2273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 95001909 (CA)

Record details

NPI number1558761395
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 29, 2014
Last updated in NPPESMay 26, 2023
Certification dateNovember 30, 2022
Mailing address1203 W 164th St Apt 3, Gardena, CA 90247-4885

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Downey