Provider Demographics
NPI:1386030054
Name:PRICE, DENITA (PA-C)
Entity Type:Individual
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First Name:DENITA
Middle Name:
Last Name:PRICE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1331 BERKELEY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2528
Mailing Address - Country:US
Mailing Address - Phone:903-343-7583
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE STE 105
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6834
Practice Address - Country:US
Practice Address - Phone:949-212-8339
Practice Address - Fax:949-502-8887
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2023-01-24
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical