Individual
GRETA MARLA VINES-DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
815 WASHINGTON BLVD, MONTEBELLO, CA 90640-6123
(323) 728-3955
(323) 728-6905
Mailing address
5823 YORK BLVD # 3, LOS ANGELES, CA 90042-2634
(323) 255-5643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13987
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00381919
MEDICARE RAILROAD
GA
Enumeration date
03/12/2007
Last updated
01/11/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us