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General NPI Number Information
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NPI Number | 1225065360
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Entity Type | Individual
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Provider Name | KALA NAKEBA PARKER MD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 147 N BRENT ST
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City | VENTURA
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State | CA
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Zip | 93003-2809
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Country | US
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Telephone | 805-652-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 5855 OLIVAS PARK DR
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City | VENTURA
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State | CA
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Zip | 93003-7672
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Country | US
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Telephone | 805-667-2801
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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 | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | MD424435
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | A78484
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License Number State | CA
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