Individual
CRAIG RANDALL PARENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3901 LAS POSAS RD, SUITE 102, CAMARILLO, CA 93010-1501
(805) 383-3668
(805) 383-3661
Mailing address
3901 LAS POSAS RD, SUITE 102, CAMARILLO, CA 93010-1501
(805) 383-3668
(805) 383-3661
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4710
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E4710
MEDICARE ID
CA
Enumeration date
06/10/2005
Last updated
10/14/2010
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