MEDICARE: EMILY SHARON PARKHURST M.S., C.G.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1134108087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY SHARON PARKHURST M.S., C.G.C

Provider Business Mailing Address
First Line	:	9014 RAYFORD DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3456
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6041 CADILLAC AVE
Second Line	:	VENICE BUILDING, 3RD FLOOR
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-1702
Country	:	US
Telephone Number	:	323-857-4109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	07/08/2007

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