Dermatology
LILY PARK D.O.
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1124333455 · enumerated 2010-08-11 · record updated 2024-08-08. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 600 COFFEE RD, MODESTO, CA, 95355-4201 (209) 521-6097 Google Maps Apple Maps OpenStreetMap
- Mailing address 3105 CEDAR RAVINE RD, STE 201, PLACERVILLE, CA, 95667-6561 (530) 626-1602 Google Maps Apple Maps OpenStreetMap
Specialties
- Internal Medicine 207R00000X · License 20A12765 CA
- Internal Medicine 207R00000X · License 5101018747 MI
- Internal Medicine 207R00000X · License DO184048 OR
- Hospitalist 208M00000X · License 20A12765 CA
- Dermatology 207N00000X · Primary · License 12765 CA
In this directory
Locations and evidence
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Practice location
MODESTO, CA, 953554201
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.