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General NPI Number Information
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NPI Number | 1013347590
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Entity Type | Individual
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Provider Name | CHARLES BRIAN PARKS D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 2550 23RD ST BUILDING 9, 2ND FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94110
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Country | US
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Telephone | 415-206-8812
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 23RD ST BUILDING 9, 2ND FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94110
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Country | US
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Telephone | 415-206-8812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | EL1961
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5253
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License Number State | CA
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