MEDICARE: CHERRYN PARQUE PA-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	363A00000X	Physician Assistant	63331	CA

General Provider Information

NPI Number	:	1841076684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERRYN PARQUE PA-C

Provider Business Mailing Address
First Line	:	1919 W 7TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 W 7TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4103
Country	:	US
Telephone Number	:	866-981-3002
Fax Number	:	213-483-1711

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

Provider Enumeration Date	:	09/07/2023
Last Update Date	:	03/17/2026

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Directions to “ CHERRYN PARQUE PA-C” Practice Location

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