Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G077150 | CA |
N | 111NI0900X | Internist | G077150 | CA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | G077150 | CA |
NPI | 1053393835 |
---|---|
Provider Name | Dr. Steven Griffen |
First Address | Sacramento, CA 95864-1567 |
Second Address | Sacramento, CA 95817-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BG3917955 | DEA (01) | CA |
F76609 | (02) | CA |
G077150 | MEDICAL LICENSE (01) | CA |