Provider Demographics
NPI:1043607229
Name:MARY PARR, L.AC
Entity Type:Organization
Organization Name:MARY PARR, L.AC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:323-513-3431
Mailing Address - Street 1:4237 STILLWELL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-1231
Mailing Address - Country:US
Mailing Address - Phone:323-513-3431
Mailing Address - Fax:
Practice Address - Street 1:1015 HOPE ST
Practice Address - Street 2:SUITE C
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2510
Practice Address - Country:US
Practice Address - Phone:323-513-3431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16598171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty