Provider Demographics
NPI:1316094758
Name:BAILEY, GRIFFIN BENJAMIN JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:GRIFFIN
Middle Name:BENJAMIN
Last Name:BAILEY
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:6085 N 1ST ST
Mailing Address - Street 2:STE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5465
Mailing Address - Country:US
Mailing Address - Phone:559-867-4416
Mailing Address - Fax:559-867-3010
Practice Address - Street 1:6085 N 1ST ST
Practice Address - Street 2:STE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5465
Practice Address - Country:US
Practice Address - Phone:559-867-4415
Practice Address - Fax:559-867-3010
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
CAPA21688363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No111N00000XChiropractic ProvidersChiropractor