Provider Demographics
NPI:1053454967
Name:SKINNER-RILEY, MARJORIE ANN (MS HCA, PA-C)
Entity type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:ANN
Last Name:SKINNER-RILEY
Suffix:
Gender:F
Credentials:MS HCA, PA-C
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Mailing Address - Street 1:5811 S CORNING AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1401
Mailing Address - Country:US
Mailing Address - Phone:310-568-8602
Mailing Address - Fax:310-568-8602
Practice Address - Street 1:403 S LONG BEACH BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-3449
Practice Address - Country:US
Practice Address - Phone:323-774-6551
Practice Address - Fax:310-763-2315
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA14132363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant