Healthcare Provider Details

I. General information

NPI: 1386030054
Provider Name (Legal Business Name): DENITA CARTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3831 HUGHES AVE STE 105
CULVER CITY CA
90232-6834
US

IV. Provider business mailing address

1331 BERKELEY ST APT 2
SANTA MONICA CA
90404-2528
US

V. Phone/Fax

Practice location:
  • Phone: 949-212-8339
  • Fax: 949-502-8887
Mailing address:
  • Phone: 903-343-7583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: