OrganizationActive
Jeong Sik Park MD a Prof Corp
NPI 1558524306 · Specialist · Clearlake, CA
Jeong Sik Park MD a Prof Corp is a Specialist organization in Clearlake, CA (NPI 1558524306).
Provider details
- NPI number
- 1558524306
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Colleen Bradrick, Medical Biller(707) 994-8818
- License
- A45408 (CA)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
15250 Lakeshore Dr Ste C
Clearlake, CA 95422-8107
Phone: (707) 995-7077
Street-level locationGet directions
Mailing address
Po Box 6017
Clearlake, CA 95422-6017
Registry dates
- Enumerated
- 2008-07-02
- Last updated
- 2008-07-02
Frequently asked questions
- What is Jeong Sik Park MD a Prof Corp's NPI number?
- Jeong Sik Park MD a Prof Corp's National Provider Identifier (NPI) is 1558524306, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jeong Sik Park MD a Prof Corp?
- Jeong Sik Park MD a Prof Corp is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Jeong Sik Park MD a Prof Corp located?
- Jeong Sik Park MD a Prof Corp's practice location on file with NPPES is 15250 Lakeshore Dr Ste C, Clearlake, CA 95422-8107.
- What is Jeong Sik Park MD a Prof Corp's phone number?
- The practice phone number listed in the NPPES registry for Jeong Sik Park MD a Prof Corp is (707) 995-7077.
- Who is the authorized official for Jeong Sik Park MD a Prof Corp?
- The authorized official listed on Jeong Sik Park MD a Prof Corp's NPPES record is Colleen Bradrick, Medical Biller. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jeong Sik Park MD a Prof Corp's NPI active?
- Yes — Jeong Sik Park MD a Prof Corp's NPI (1558524306) is active in the NPPES registry as of the last update on 2008-07-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.