Provider Demographics
NPI:1558085712
Name:PARENTIS HEALTH PROVIDER NETWORK, P.C.
Entity Type:Organization
Organization Name:PARENTIS HEALTH PROVIDER NETWORK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARDJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:949-230-3797
Mailing Address - Street 1:24012 CALLE DE LA PLATA STE 400
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7623
Mailing Address - Country:US
Mailing Address - Phone:833-247-9111
Mailing Address - Fax:
Practice Address - Street 1:24012 CALLE DE LA PLATA STE 400
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7623
Practice Address - Country:US
Practice Address - Phone:833-247-9111
Practice Address - Fax:949-215-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty