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General NPI Number Information
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NPI Number | 1336215359
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Entity Type | Individual
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Provider Name | GAEL PARKS L.AC.
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 3808 W RIVERSIDE DR SUITE #302
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City | BURBANK
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State | CA
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Zip | 91505-4325
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Country | US
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Telephone | 818-563-6179
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Fax | 818-558-5638
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Provider Business Mailing Address
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Address Line | 11650 RIVERSIDE DR STE 8
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City | STUDIO CITY
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State | CA
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Zip | 91602-1066
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Country | US
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Telephone | 818-760-4808
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Fax | 818-760-4809
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC5229
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License Number State | CA
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