Organization
CALNUERO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENITH PARESA MD (TREATING PHYSICIAN)
(323) 424-4721
Entity
Organization
Contact information
Practice address
8421 WILSHIRE BLVD, 105, BEVERLY HILLS, CA 90211-3225
(323) 424-4721
Mailing address
8421 WILSHIRE BLVD, 105, BEVERLY HILLS, CA 90211-3225
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
A66233
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A662330
—
CA
Enumeration date
02/28/2011
Last updated
02/28/2011
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