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Jeong Sik Park MD A Prof Corp

Specialist in Clearlake, CA · enumerated 2008 · authorized official Colleen Bradrick, Medical Biller.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1558524306

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Registry record

Entity type Organization (Type 2)
Legal business name Jeong Sik Park MD A Prof Corp
Practice address 15250 Lakeshore Dr Ste C, Clearlake, CA, 95422
Phone (707) 995-7077
Enumeration date Jul 2, 2008
Last updated in NPPES Jul 2, 2008

Taxonomy & classification

174400000X Specialist Other Service Providers · License A45408 (CA) Primary

Authorized official

Name Colleen Bradrick
Title Medical Biller
Phone (707) 994-8818

Other identifiers

Identifier Type State Issuer
00A454080 Medicaid CA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Jeong Sik Park MD A Prof Corp?
The NPI for Jeong Sik Park MD A Prof Corp is 1558524306, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Jeong Sik Park MD A Prof Corp?
NPPES lists Colleen Bradrick (Medical Biller) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-07-02.