Organization
KERRI S. PARKS, M. D., A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRI SHANE PARKS M.D. (PRESIDENT/ M.D.)
(818) 952-5322
Entity
Organization
Contact information
Practice address
1808 VERDUGO BLVD, #208, GLENDALE, CA 91208-1477
(818) 952-5322
(818) 952-7993
Mailing address
1808 VERDUGO BLVD, #208, GLENDALE, CA 91208-1477
(818) 952-5322
(818) 952-7993
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0102260
—
CA
Enumeration date
12/07/2007
Last updated
08/06/2009
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