Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G83040 | CA |
NPI | 1083609390 |
---|---|
Provider Name | Dr. Christine Louise Griswold |
First Address | Rancho Mirage, CA 92270-3221 |
Second Address | Rancho Mirage, CA 92270-3221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 20/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F85522 | (02) |