Healthcare Provider Details

I. General information

NPI: 1629261813
Provider Name (Legal Business Name): AARON LEWIS GRIFFIN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 CHICAGO AVE SUITE J3
RIVERSIDE CA
92507-2300
US

IV. Provider business mailing address

1760 CHICAGO AVE SUITE J3
RIVERSIDE CA
92507-2300
US

V. Phone/Fax

Practice location:
  • Phone: 951-781-2200
  • Fax: 909-781-2220
Mailing address:
  • Phone: 951-781-2200
  • Fax: 909-781-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number20201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: