Provider Demographics
NPI:1437186285
Name:GRIFFITH, PATRICK KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:KEITH
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24411 HEALTH CENTER DRIVE
Mailing Address - Street 2:STE 680
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-268-4568
Mailing Address - Fax:949-455-2795
Practice Address - Street 1:24411 HEALTH CENTER DRIVE
Practice Address - Street 2:STE 680
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-268-4568
Practice Address - Fax:949-455-2795
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51011208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1437186285Medicaid
CAZZZ33841ZOtherBLUE SHIELD PIN #
CAP00202517OtherRAILROAD MEDICARE
CAP00202517OtherRAILROAD MEDICARE
CA00C510110Medicare PIN