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

Soo Yeun Park

Individual provider Family Medicine Physician · NPI 1528565371

Soo Yeun Park is a Family Practice in Brea, California. Qualified in 2018, 8 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2018
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Practice location Address checks out

955 W Imperial Hwy
Brea, CA 92821-3812
Phone: (714) 449-6900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11234 Anderson St, Loma Linda, CA 92354-2804 — (909) 558-6688

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 20A17740 (CA)

Record details

NPI number1528565371
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 9, 2018
Last updated in NPPESAugust 24, 2021
Certification dateAugust 24, 2021
Mailing address955 W Imperial Hwy, Brea, CA 92821-3812

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Brea