Healthcare Provider Details

I. General information

NPI: 1770067233
Provider Name (Legal Business Name): RACHEL LORRAINE GRIGGS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4786 PECK RD
EL MONTE CA
91732-1665
US

IV. Provider business mailing address

1727 N EDGEMONT ST APT 5
LOS ANGELES CA
90027-4148
US

V. Phone/Fax

Practice location:
  • Phone: 800-576-5544
  • Fax:
Mailing address:
  • Phone: 585-472-3413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number95166988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: