Kerry Park is a Specialist in Los Angeles, California. Kerry Park practices all healthcare services and medical treatments related to Specialist. The NPI Number for Kerry Park is 1962497149. The last update date is 2019-04-05.
Kerry Park's current location address is 2801 S San Pedro St, Los Angeles, California. You can contact this provider via phone number 3232333100 and fax number 3232334100. The mailing address for Kerry Park is 2801 S San Pedro St, Los Angeles, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kerry Park |
|---|---|
| Address | 2801 S San Pedro St, Los Angeles, California |
| Phone Number | 3232333100 |
| Fax Number | 3232334100 |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1962497149 |
|---|---|
| Provider Enumeration Date | 2005-09-14 |
| Last Updated Date | 2019-04-05 |
Provider Mailing Address Detail
| Address | 2801 S San Pedro St |
|---|---|
| City | Los Angeles |
| State | California (CA) |
| Post Code | 900112023 |
| Phone Number | 3232333100 |
| Fax Number | 3232334100 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | G77252 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 522355131 | CA | TAX ID # | |
| 00G772520 | CA | -- | |
| G39493 | CA | PTAN |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Kerry Park by the Centers for Medicare & Medicaid Services?
The Kerry Park has been assigned the NPI (National Provider Identifier) 1962497149 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Kerry Park is located?
The Kerry Park is situated at the following address: 2801 S San Pedro St, Los Angeles, CA, 900112023.
What is the Kerry Park's specialty and taxonomy code?
The Kerry Park's specialty is Specialist, and the corresponding taxonomy code is 174400000X.
On what date did Kerry Park receive its 1962497149 assignment from the Centers for Medicare & Medicaid Services?
The Kerry Park was assigned its 1962497149 on 2005-09-14, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Kerry Park most recently updated?
The details pertaining to the Kerry Park, including its address, specialty, and other relevant information, were last refreshed on 2019-04-05.