Individual
GRACE JEAN-PIERRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2101 ROSECRANS AVE # 3230, EL SEGUNDO, CA 90245-4749
(323) 628-8671
Mailing address
1414 S GRAND AVE, SUITE 100, LOS ANGELES, CA 90015-3067
(213) 481-2200
(213) 481-7023
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15266
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA15266
STATE LICENSE
CA
05
—
WPA15266A
—
CA
Enumeration date
11/13/2006
Last updated
10/24/2019
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