| Kenneth D. Parola, D.o., Inc. | |
|
2045 Royal Ave Suite 121 Simi Valley CA 93065-4665 | |
| (808) 526-4380 | |
| (805) 520-0431 |
| Full Name | Kenneth D. Parola, D.o., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2045 Royal Ave, Simi Valley, California |
| Authorized Official Name and Position | Kenneth D. Parola (PRESIDENT) |
| Authorized Official Contact | 8055264380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth D. Parola, D.o., Inc. 2045 Royal Ave Suite 121 Simi Valley CA 93065-4665 Ph: (808) 526-4380 | Kenneth D. Parola, D.o., Inc. 2045 Royal Ave Suite 121 Simi Valley CA 93065-4665 Ph: (808) 526-4380 |
| NPI Number | 1790838530 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790838530 | NPI | - | NPPES |
| 020A41520 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A4152 (California) | Primary |
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