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General NPI Number Information
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NPI Number | 1417737297
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Entity Type | Organization
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Legal Business Name | G.A. E GRIFFIN, PH.D., INC
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Dates
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Enumeration Date | 09/29/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 1600 CAMPUS RD
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City | LOS ANGELES
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State | CA
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Zip | 90041-3314
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Country | US
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Telephone | 323-471-1067
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 CAMPUS RD
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City | LOS ANGELES
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State | CA
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Zip | 90041-3314
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Country | US
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Telephone | 323-471-1067
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GLENN GRIFFIN
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Credential | PHD
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Telephone | 323-471-1067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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