Provider Demographics
NPI:1306921317
Name:GRIFFO, MICHAEL G (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:GRIFFO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8907 WARNER AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5075
Mailing Address - Country:US
Mailing Address - Phone:714-842-6122
Mailing Address - Fax:714-375-2591
Practice Address - Street 1:8907 WARNER AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5075
Practice Address - Country:US
Practice Address - Phone:714-842-6122
Practice Address - Fax:714-375-2591
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC12183Medicare ID - Type Unspecified
CAT04659Medicare UPIN