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General NPI Number Information
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NPI Number | 1225879729
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Entity Type | Individual
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Provider Name | DARIEN GRAY DPT
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Gender | Male
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 3283 MOTOR AVE
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City | LOS ANGELES
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State | CA
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Zip | 90034-3709
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Country | US
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Telephone | 310-845-9690
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Fax |
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Provider Business Mailing Address
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Address Line | 3338 W 79TH ST
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City | INGLEWOOD
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State | CA
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Zip | 90305-1347
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 306109
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License Number State | CA
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