Healthcare Provider Details

I. General information

NPI: 1780066373
Provider Name (Legal Business Name): DR KAMRAN PARSA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W AVENUE M4
PALMDALE CA
93551-1432
US

IV. Provider business mailing address

1120 W AVENUE M4
PALMDALE CA
93551-1432
US

V. Phone/Fax

Practice location:
  • Phone: 661-480-2377
  • Fax: 661-480-2378
Mailing address:
  • Phone: 661-480-2377
  • Fax: 661-480-2378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number20A11025
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAMRAN PARSA
Title or Position: NEUROSURGEON/PRESIDENT
Credential: DO
Phone: 661-480-2377