MEDICARE: DR. MICHAEL DAVID PARISER PSY.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	103T00000X	Psychologist	PSY20038	CA

General Provider Information

NPI Number	:	1699980573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DAVID PARISER PSY.D.

Provider Business Mailing Address
First Line	:	3513 PURDUE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-2909
Country	:	US
Telephone Number	:	310-926-8450
Fax Number	:

Provider Business Practice Location Address
First Line	:	1145 GAYLEY AVE
Second Line	:	SUITE #322
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-3423
Country	:	US
Telephone Number	:	310-208-7187
Fax Number	:

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

Provider Enumeration Date	:	05/13/2007
Last Update Date	:	07/08/2007

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