Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E5253 | CA |
N | 213ES0103X | Foot & Ankle Surgery | EL1961 | CA |
NPI | 1013347590 |
---|---|
Provider Name | Dr. Charles Brian Parks |
First Address | San Francisco, CA 94110 |
Second Address | San Francisco, CA 94110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2013 |
Last Update Date | 14/09/2018 |