DR. CHAN H. PARK (M.D.) – Family Medicine Physician, NPI 1255336665

DR. CHAN H. PARK (M.D.) is a healthcare provider. based in Shafter, California. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. A068509 (CA). The NPI Number for DR. CHAN H. PARK (M.D.) is 1255336665

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHAN H. PARK (M.D.)
NPI
1255336665
Phone
(661) 459-1010
Address
565 KERN ST
Enumeration Date
14 June 2005
Last Update Date
1 May 2026

Doctor Profile

Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6614292739
Graduation Year
1996 (30 years ago)
PAC ID
7517995384
Group Practice PAC ID
9133494578
Professional Enrollment ID
I20050908001225
Address ID
CA932632052SH501XXSTXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

13,194 FAMILY PRACTICE in CA

Provider Addresses for DR. CHAN H. PARK (M.D.)

  • 565 KERN ST

    SHAFTER, CA 932632133

    Phone: (661) 459-1010

    Fax: (855) 200-2829

    Type: Mailing

  • Stockdale Highway, Bakersfield, Kern County, California, 93314, United States

    SUITE 203

    BAKERSFIELD, CA 933113620

    Phone: (661) 587-8110

    Fax: (661) 587-8220

    Type: Mailing

  • 500 OLD RIVER RD STE 250

    BAKERSFIELD, CA 933119515

    Phone: (661) 459-1010

    Fax: (855) 200-2829

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 60 Open Payments records for all available years, with a total value of $1,084.

Total Amount is formed as General ($1,084) + Research ($0) + Ownership ($0) = $1,084.

Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Novo Nordisk Inc ($192).

Total Amount

$1,084

General + Research + Ownership

Payments

60

Total payment records

General Amount

$1,084

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-07

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-09-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050908001225IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes351130$0
81002Urinalysis, manual test282181$0
87811Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)208164$0
87804Detection test by immunoassay with direct visual observation for influenza virus18081$0
82962Blood glucose (sugar) test performed by hand-held instrument12672$0
View full utilization report →

Insurance plans in this area (ZIP 93263)

Loading plans...

Provider's Procedures

DR. CHAN H. PARK (M.D.) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINECA81002Urinalysis, manual test1918
FAMILY MEDICINECA90670Pneumococcal vaccine for injection into muscle4545

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9133494578View full group profile
NameSpecialtyState
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do payers reference DR. CHAN H. PARK (M.D.)?
For DR. CHAN H. PARK (M.D.), use NPI 1255336665 as the unique 10-digit identifier.
Active or inactive — what applies to DR. CHAN H. PARK (M.D.)?
You should see DR. CHAN H. PARK (M.D.) as active in CMS-hosted NPPES data.
What area of care is associated with DR. CHAN H. PARK (M.D.)?
DR. CHAN H. PARK (M.D.)'s record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in California is DR. CHAN H. PARK (M.D.) registered?
Use Shafter, California as the headline location for DR. CHAN H. PARK (M.D.) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

Similar Providers

JAE JOON KIM (MD)

Family Medicine Physician
565, Kern Street, Shafter, Kern County, California, 93263, United States
NPI: 1841264918

MICHAEL L. KOMIN (M.D.)

Family Medicine Physician
1160 E LERDO HWY STE H
NPI: 1437104858
100 OLD RIVER RD STE 110
NPI: 1396935862

DR. KAMRUN NAHER (M.D.)

Family Medicine Physician
655 S Central Valley Hwy
NPI: 1578723110

ISIS SAMANTA MACIAS MORENO (M.D)

Family Medicine Physician
2810 W. EXPRESSWAY 83
NPI: 1720604853

ADVENTIST HEALTH PHYSICIANS NETWORK

Family Medicine Physician
PO BOX 888794
NPI: 1649958562

ALVAREZ HEALTHCARE

Internal Medicine Physician
PO BOX 640
NPI: 1477350817