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General NPI Number Information
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NPI Number | 1427449339
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Entity Type | Organization
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Legal Business Name | ELEONOR LOYOLA GRIFFITH, DO, PC
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 1611 CREEKSIDE DR STE 101
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City | FOLSOM
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State | CA
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Zip | 95630-3490
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Country | US
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Telephone | 916-984-9004
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 CREEKSIDE DR STE 101
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City | FOLSOM
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State | CA
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Zip | 95630-3490
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Country | US
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Telephone | 916-984-9004
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELEONOR LOYOLA GRIFFITH
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Credential | D.O.
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Telephone | 916-984-9004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A0A12052
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License Number State | CA
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