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NPI Code Detail

MEDICARE: GREGORY SWILLEY

MEDICARE: GREGORY SWILLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCA

General Provider Information

NPI Number : 1962329003
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY SWILLEY
Provider Business Mailing Address
First Line : 2032 MARENGO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1319
Country : US
Telephone Number : 323-987-1034
Fax Number : 323-987-1034
Provider Business Practice Location Address
First Line : 2032 MARENGO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1319
Country : US
Telephone Number : 323-987-1034
Fax Number : 323-987-1034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2026
Last Update Date : 06/30/2026

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Directions to “ GREGORY SWILLEY ” Practice Location

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