Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1538864335 Individual Practitioner Male Practitioner

Dr. Shawn Seung Dae Park , MD

General Practice • Fairfield, CA

Professional Overview & Biography Verified Profile Summary

Dr. Shawn Park, MD is a registered healthcare professional specializing in General Practice in Fairfield, CA. Practice services are available at 101 BODIN CIR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

101 Bodin Cir

Fairfield, CA 945351809

Telephone 7074233792
Fax 7074233501
Associated Practice Facility / Clinic
🏢 Usaf Facility NPI 1750365003

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Fairfield, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 31.1 Yrs
Regional Practice Density
14 Specialists

Practicing in Fairfield, CA (2300 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-08-13
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License IN 01097499A

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Military Health Care Provider

NUCC Taxonomy Code: 171000000X

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
NPI 1104967694

Doctor of Osteopathic Medicine (D.O.)

NPI 1174212997

Doctor of Medicine (M.D.)

Kevin Roy

General Practice

NPI 1275228520
NPI 1356723191

Doctor of Medicine (M.D.)

Dr. Amy Davis , MD

Family Medicine

NPI 1366621799

Doctor of Medicine (M.D.)

Dr. William Kieffer , PhD

Social Worker - Clinical

NPI 1619964285

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location August 13, 2025

Registered at 101 BODIN CIR, FAIRFIELD, CA 945351809 (Tel: 7074233792)

📍
Updated Business Mailing Address August 13, 2025

Registered at 101 BODIN CIR, FAIRFIELD, CA 945351809 (Tel: 7074233792)

📍
Updated Practice Location June 25, 2024

Registered at 1000 ALLISON DR APT 148, VACAVILLE, CA 956874986 (Tel: 7147959059)

📍
Updated Business Mailing Address June 25, 2024

Registered at 1000 ALLISON DR APT 148, VACAVILLE, CA 956874986

👤
Provider Name / Credentials Updated June 25, 2024

Recorded as SHAWN PARK, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2024

Military Health Care Provider

NPI Profile Active April 03, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location April 03, 2023

Registered at 32229 CEDAR CREST CT, TEMECULA, CA 925924160 (Tel: 7147959059)

📍
Updated Business Mailing Address April 03, 2023

Registered at 32229 CEDAR CREST CT, TEMECULA, CA 925924160

👤
Provider Name / Credentials Updated April 03, 2023

Recorded as SHAWN PARK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 03, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1538864335
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 03, 2023
Last Update: August 13, 2025
Sole Proprietor: No

Mailing Address

101 Bodin Cir

Fairfield, CA 945351809

Phone: 7074233792

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.