Provider Demographics
NPI:1467464941
Name:PARSA, PARVIZ
Entity Type:Individual
Prefix:DR
First Name:PARVIZ
Middle Name:
Last Name:PARSA
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:HARVEY
Other - Middle Name:
Other - Last Name:PARSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:23712 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-5744
Mailing Address - Country:US
Mailing Address - Phone:310-830-5275
Mailing Address - Fax:310-830-2361
Practice Address - Street 1:23712 MAIN ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-5744
Practice Address - Country:US
Practice Address - Phone:310-830-5275
Practice Address - Fax:310-830-2361
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC27931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine