Provider Demographics
NPI:1447292198
Name:KRIS PAREL INC.
Entity type:Organization
Organization Name:KRIS PAREL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIFOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-344-0017
Mailing Address - Street 1:2313 W OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2627
Mailing Address - Country:US
Mailing Address - Phone:323-344-0017
Mailing Address - Fax:323-344-8900
Practice Address - Street 1:2313 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2627
Practice Address - Country:US
Practice Address - Phone:323-344-0017
Practice Address - Fax:323-344-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA058192251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08192FMedicaid
CAHHA08192FMedicaid