Griffith, Jack W
Griffith, Jack W is an sole proprietor health care provider with primary practice located at 7365 Carnelian St Suite 137, Rancho Cucamonga CA 91730-1158. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Griffith, Jack W can be contacted via phone (909) 948-8888.Contact Information
Primary practice address
7365 Carnelian St Suite 137
Rancho Cucamonga CA 91730-1158
Phone: (909) 948-8888
Fax: (909) 948-8839
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 20A9405 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 20A9405 | California |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 20A9405 | California |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 20A9405 | California |
Profile Details
| NPI number | 1407884315 |
|---|---|
| LBN Legal business name | Griffith, Jack W |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Nov 7th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407884315 | NPPES |
| California | MEDICAID | 00AX94050 |
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