Individual
MR. PERRY LEWIS MADDOX SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
(213) 598-0980
Mailing address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
(213) 684-3225
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
04/01/2025
Last updated
07/01/2026
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