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

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