Andrew Park, MD

Public-record details

Address

11645 Wilshire Blvd Ste 900, Los Angeles, CA 90025

Phone

(424) 243-7668

Listed under

Individual clinicians

NPI

1033678305

NPI status

Active in the NPPES registry

Provider type

Individual provider

Registered specialty (self-reported taxonomy)

Dermatology (207N00000X)

Credentials listed

MD

License number on NPI record

A188055 (CA)

NPI first issued

Mar 17, 2019

Years since NPI first issued

7 years (since 2019)

License state on NPI record

CA

NPI record last updated

May 12, 2026

Medicare enrollment (CMS)

Enrolled: listed in CMS Doctors & Clinicians

Medicare assignment (CMS)

Accepts the Medicare-approved amount as payment in full

Professional school graduation (CMS)

2019 (7 years ago)

Professional school (CMS)

Geisel School of Medicine at Dartmouth

Medicare group practice (CMS)

Southern California Permanente Medical Group (11,293 clinicians); J Robert West MD INC (138 clinicians); Dermatology Associates of Beverly Hills (8 clinicians)

Practice locations on file with Medicare (CMS)

3

Other practice locations (NPPES)

1: Long Beach, CA

Other dermatology listings at this street address

2

NPI 1033678305 is active in the federal NPPES registry (CMS) with Dermatology as its self-reported primary taxonomy; license A188055 (CA) is listed on the record. CMS Doctors & Clinicians lists this clinician as enrolled in Medicare. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.

Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Dermatologist Index does not vet, employ, recommend or guarantee dermatology practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Dermatologist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an individual clinician. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. A registered specialty is not board certification. To check board certification, use the American Board of Dermatology's verification tool (or the American Osteopathic Board of Dermatology for DOs), and confirm the medical license with the state board.

View NPI 1033678305 in the official registry ↗

Practices and clinicians at this address

Other listings in this directory whose NPI record gives the same street address and ZIP. A shared address usually means a shared practice or building; it does not by itself show who works with whom.

• Casey Lubner, MD
• Stephen Baccari, NP