Individual
DEALIE ELIZABETH PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
30870 RUSSELL RANCH RD STE 330, WESTLAKE VILLAGE, CA 91362-7372
(805) 497-7015
(805) 497-7315
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA15401
CA
363AS0400X
Surgical Physician Assistant
PA15401
CA
Other
Enumeration date
08/16/2006
Last updated
05/01/2024
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