Individual
ANDREW T GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
150 N ROBERTSON BLVD, SUITE 300, BEVERLY HILLS, CA 90211-2142
(310) 652-2562
(310) 652-2843
Mailing address
8660 BURTON WAY, APT 204, LOS ANGELES, CA 90048-3969
(917) 696-8525
(310) 652-2843
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA22797
CA
363AM0700X
Medical Physician Assistant
PA22797
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA22797
MEDICAL LICENSE NUMBER
CA
Enumeration date
01/29/2013
Last updated
10/28/2013
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