MEDICARE: DR. DENISE LYNETTE PARNELL M.D.

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	207R00000X	Internal Medicine Physician	CAG78556	CA

General Provider Information

NPI Number	:	1366477648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE LYNETTE PARNELL M.D.

Provider Business Mailing Address
First Line	:	823 GATEWAY CENTER WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92102-4541
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8788 JAMACHA RD
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-4035
Country	:	US
Telephone Number	:	619-515-2300
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	10/27/2008

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