Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | A78484 | CA |
N | 2080P0204X | Pediatric Emergency Doctor | MD424435 | PA |
NPI | 1225065360 |
---|---|
Provider Name | Kala Nakeba Parker |
First Address | Ventura, CA 93003-7672 |
Second Address | Ventura, CA 93003-2809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 09/06/2016 |