Healthcare Provider Details

I. General information

NPI: 1518325026
Provider Name (Legal Business Name): LIANN GRIFFITHS O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LAGUNA RD SUITE C
FULLERTON CA
92835-3634
US

IV. Provider business mailing address

235 N MILFORD ST
ORANGE CA
92867-7815
US

V. Phone/Fax

Practice location:
  • Phone: 714-888-2080
  • Fax:
Mailing address:
  • Phone: 714-492-0118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT # 33341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: