Provider Demographics
NPI:1609968320
Name:PARNELL, STEPHEN AC (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:AC
Last Name:PARNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2501 PESQUERA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1226
Mailing Address - Country:US
Mailing Address - Phone:310-680-6850
Mailing Address - Fax:310-680-6855
Practice Address - Street 1:501 E HARDY ST
Practice Address - Street 2:SUITE 430
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4054
Practice Address - Country:US
Practice Address - Phone:310-671-7010
Practice Address - Fax:310-680-6855
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG45223207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0027410Medicaid
CAW10374AMedicare PIN
CAA92560Medicare UPIN