MEDICARE: DAVID LEROY PARSONS DO

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	207Q00000X	Family Medicine Physician	20A11123	CA

General Provider Information

NPI Number	:	1679501894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID LEROY PARSONS DO

Provider Business Mailing Address
First Line	:	8830 SCOTT'S VALLEY RD
Second Line	:
City	:	UPPER LAKE
State	:	CA
Zip	:	95485-9541
Country	:	US
Telephone Number	:	707-263-7478
Fax Number	:

Provider Business Practice Location Address
First Line	:	8830 SCOTTS VALLEY RD
Second Line	:
City	:	UPPER LAKE
State	:	CA
Zip	:	95485-9541
Country	:	US
Telephone Number	:	707-263-7478
Fax Number	:

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	06/21/2012

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