Provider Demographics
NPI:1104555366
Name:SOCALPHYSICIANSHOUSECALLCORP
Entity type:Organization
Organization Name:SOCALPHYSICIANSHOUSECALLCORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BARNETT
Authorized Official - Middle Name:JOHN WESLEY
Authorized Official - Last Name:GRIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD MBA
Authorized Official - Phone:323-828-7929
Mailing Address - Street 1:231 W VERNON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2779
Mailing Address - Country:US
Mailing Address - Phone:323-828-7929
Mailing Address - Fax:
Practice Address - Street 1:231 W VERNON AVE STE 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2779
Practice Address - Country:US
Practice Address - Phone:323-828-7929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-05
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty