Organization
MARINA WOMEN'S MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE GENE PARKS M.D. (MD/OWNER)
(310) 822-5066
Entity
Organization
Contact information
Practice address
4560 ADMIRALTY WAY, 303, MARINA DEL REY, CA 90292-5423
(310) 822-5066
(310) 827-4420
Mailing address
4560 ADMIRALTY WAY, 303, MARINA DEL REY, CA 90292-5423
(310) 822-5066
(310) 827-4420
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C35271
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C352710
—
CA
Enumeration date
07/20/2006
Last updated
07/13/2010
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