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General NPI Number Information
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NPI Number | 1316094758
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Entity Type | Individual
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Provider Name | GRIFFIN BENJAMIN BAILEY JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6085 N 1ST ST STE 101
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City | FRESNO
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State | CA
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Zip | 93710-5465
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Country | US
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Telephone | 559-867-4415
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Fax | 559-867-3010
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Provider Business Mailing Address
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Address Line | 6085 N 1ST ST STE 101
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City | FRESNO
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State | CA
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Zip | 93710-5465
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Country | US
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Telephone | 559-867-4416
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Fax | 559-867-3010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA21688
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License Number State | CA
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