Provider Demographics
NPI:1992228415
Name:DR RONNA PARSA A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:DR RONNA PARSA A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNA
Authorized Official - Middle Name:SIMIN
Authorized Official - Last Name:PARSA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-991-7699
Mailing Address - Street 1:510 N PROSPECT AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3030
Mailing Address - Country:US
Mailing Address - Phone:310-372-4646
Mailing Address - Fax:310-798-4667
Practice Address - Street 1:510 N PROSPECT AVE STE 105
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3030
Practice Address - Country:US
Practice Address - Phone:310-372-4646
Practice Address - Fax:310-798-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A15524207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty