Provider Demographics
NPI:1356568752
Name:GREY, ERLINDA DY (MD)
Entity type:Individual
Prefix:DR
First Name:ERLINDA
Middle Name:DY
Last Name:GREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ERLINDA
Other - Middle Name:DY
Other - Last Name:GREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8215 VAN NUYS BLVD
Mailing Address - Street 2:210-204
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4810
Mailing Address - Country:US
Mailing Address - Phone:818-901-0373
Mailing Address - Fax:818-782-7320
Practice Address - Street 1:8215 VAN NUYS BLVD
Practice Address - Street 2:210-204
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4810
Practice Address - Country:US
Practice Address - Phone:818-901-0373
Practice Address - Fax:818-782-7320
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30427170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics