Parks, Kerri Shane
Parks, Kerri Shane is an individual health care provider with primary practice located at 1808 Verdugo Blvd Suite 208, Glendale CA 91208-1477. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Parks, Kerri Shane can be contacted via phone (818) 952-5322.Contact Information
Primary practice address
1808 Verdugo Blvd Suite 208
Glendale CA 91208-1477
Phone: (818) 952-5322
Fax: (818) 952-7993
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | A65496 | California |
Profile Details
| NPI number | 1104893775 |
|---|---|
| LBN Legal business name | Parks, Kerri Shane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Dec 7th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104893775 | NPPES |
| California | MEDICAID | GR0102260 |
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