Provider Demographics
NPI:1932233665
Name:GRIER, BARNETT J W JR (MD)
Entity type:Individual
Prefix:DR
First Name:BARNETT
Middle Name:J W
Last Name:GRIER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 IDAHO AVE
Mailing Address - Street 2:#5
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-3054
Mailing Address - Country:US
Mailing Address - Phone:323-828-7929
Mailing Address - Fax:310-564-7760
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:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23617207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA86684Medicare UPIN