Provider Demographics
NPI:1013181353
Name:PARKER, BRIDGET L
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:L
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 E 116TH ST
Mailing Address - Street 2:343 E. 116TH STREET
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-2913
Mailing Address - Country:US
Mailing Address - Phone:323-779-0048
Mailing Address - Fax:
Practice Address - Street 1:343 E 116TH ST
Practice Address - Street 2:343 E. 116TH STREET
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-2913
Practice Address - Country:US
Practice Address - Phone:323-779-0048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner