Provider Demographics
NPI:1649474669
Name:PARRISH, MARY CLAIRE (D,C,)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:CLAIRE
Last Name:PARRISH
Suffix:
Gender:F
Credentials:D,C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DELFINO PLACE
Mailing Address - Street 2:
Mailing Address - City:CARMEL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93924
Mailing Address - Country:US
Mailing Address - Phone:831-659-5180
Mailing Address - Fax:831-659-7569
Practice Address - Street 1:6 DELFINO PLACE
Practice Address - Street 2:
Practice Address - City:CARMEL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93924
Practice Address - Country:US
Practice Address - Phone:831-659-5180
Practice Address - Fax:831-659-7569
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 17310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC017310Medicare UPIN