Provider Demographics
NPI:1023406964
Name:GRAY MATTERS
Entity type:Organization
Organization Name:GRAY MATTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:IRA
Authorized Official - Last Name:SITZER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:213-293-9408
Mailing Address - Street 1:4315 BEETHOVEN ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-6102
Mailing Address - Country:US
Mailing Address - Phone:213-300-5440
Mailing Address - Fax:
Practice Address - Street 1:617 W 7TH ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3830
Practice Address - Country:US
Practice Address - Phone:213-293-9408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21769251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health