Organization Active NPI

Kenneth D. Parola, D.O., Inc.

  • Family Medicine Physician
  • Simi Valley, CA
National Provider Identifier
1790838530
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A4152 Issued in CA
Legal business name
KENNETH D. PAROLA, D.O., INC.
Practice address
2045 Royal Ave
Suite 121
Simi Valley, CA 93065-4665
Phone
(808) 526-4380
Fax
(805) 520-0431
NPI assigned
Jan 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenneth D. Parola, M.D.
Title
President
Phone
(805) 526-4380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A4152 CA Primary

Addresses

Primary practice location

2045 Royal Ave
Suite 121
Simi Valley, CA 93065-4665

Mailing address

2045 Royal Ave
Suite 121
Simi Valley, CA 93065-4665
Phone (808) 526-4380

Other identifiers 1

IdentifierTypeStateIssuer
020A41520MedicaidCA

National Provider Directory

National Provider Directory

Locations

2045 Royal Ave
Ste 121
Simi Valley, CA 93065
Phone (805) 526-4380

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790838530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE",
            "address_2": "SUITE 121",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654665",
            "telephone_number": "808-526-4380",
            "fax_number": "805-520-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE",
            "address_2": "SUITE 121",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654665",
            "telephone_number": "808-526-4380",
            "fax_number": "805-520-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH D. PAROLA, D.O., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAROLA",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-526-4380",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020A41520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.