Provider Demographics
NPI:1811926652
Name:PARNELL, DIANA DEANGELIS (MD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:DEANGELIS
Last Name:PARNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 S ELISEO DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2017
Mailing Address - Country:US
Mailing Address - Phone:415-461-1036
Mailing Address - Fax:415-461-1043
Practice Address - Street 1:1100 S ELISEO DR
Practice Address - Street 2:SUITE 2
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2017
Practice Address - Country:US
Practice Address - Phone:415-461-1036
Practice Address - Fax:415-461-1043
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG185710207ND0900X
CAG18571207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89294Medicare UPIN