Healthcare Provider Details

I. General information

NPI: 1255623344
Provider Name (Legal Business Name): CAREY MALIKA GRIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 05/30/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S VERMONT AVE 17TH FLR
LOS ANGELES CA
90020-1912
US

IV. Provider business mailing address

510 S. VERMONT AVE 17TH FLR
LOS ANGELES CA
90020
US

V. Phone/Fax

Practice location:
  • Phone: 213-351-7284
  • Fax: 213-947-4579
Mailing address:
  • Phone: 213-351-7284
  • Fax: 213-947-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: