Individual
DR. KERRI SHANE PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1808 VERDUGO BLVD, SUITE 208, GLENDALE, CA 91208-1477
(818) 952-5322
(818) 952-7993
Mailing address
1808 VERDUGO BLVD, SUITE 208, GLENDALE, CA 91208-1477
(818) 952-5322
(818) 952-7993
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A65496
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0102260
—
CA
Enumeration date
03/02/2006
Last updated
12/07/2007
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