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General NPI Number Information
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NPI Number | 1134259468
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Entity Type | Organization
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Legal Business Name | GRIFFIN MEDICAL GROUP
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 1650 ADAMS AVE
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City | COSTA MESA
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State | CA
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Zip | 92626-4958
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Country | US
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Telephone | 714-549-6500
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Fax | 714-549-6552
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Provider Business Mailing Address
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Address Line | 1650 ADAMS AVE
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City | COSTA MESA
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State | CA
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Zip | 92626-4958
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Country | US
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Telephone | 714-549-6500
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Fax | 714-549-6552
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ALAN GLOVER
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Credential |
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Telephone | 714-549-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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