Provider Demographics
NPI:1104939248
Name:GRIFFITHS, CHESTER F (MD, FACS)
Entity type:Individual
Prefix:
First Name:CHESTER
Middle Name:F
Last Name:GRIFFITHS
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11645 WILSHIRE BLVD
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1708
Mailing Address - Country:US
Mailing Address - Phone:310-477-5558
Mailing Address - Fax:310-477-7281
Practice Address - Street 1:11645 WILSHIRE BLVD
Practice Address - Street 2:6TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1708
Practice Address - Country:US
Practice Address - Phone:310-477-5558
Practice Address - Fax:310-477-7281
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45673207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A456730OtherMEDICAL PPIN #
CAWA45673BMedicare ID - Type UnspecifiedPPIN #
CA00A456730OtherMEDICAL PPIN #