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Contact Information

JACK W. GRIFFITH, III, D.O.
7365 CARNELIAN STREET
SUITE 137
RANCHO CUCAMONGA, CA91730-1100
 Phone: 909-948-8888
 Fax: 909-948-8888
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Clinical & Laboratory Dermatological Immunology

207NI0002X 07 Physician/Dermatology
 

Dermatopathology

207ND0900X 07 Physician/Dermatology
 

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Pediatric Dermatology

207NP0225X 07 Physician/Dermatology
 

Procedural Dermatology

207NS0135X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for JACK W. GRIFFITH, III, D.O.

NPI # 1134425036
LBN Legal business name JACK W. GRIFFITH, III, D.O.
Authorized official JACK GRIFFITH - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/10/2011
Last updated 05/28/2014 - About 12 years ago
Identifiers
CA License # 20A9405
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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