Provider Demographics
NPI:1083609390
Name:GRISWOLD, CHRISTINE LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:GRISWOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:LOUISE
Other - Last Name:MESSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:KIEWIT 405
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-568-4343
Mailing Address - Fax:760-568-9937
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:KIEWIT 405
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-568-4343
Practice Address - Fax:760-568-4343
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83040207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F85522Medicare UPIN
CA00G830400Medicare ID - Type Unspecified