Provider Demographics
NPI:1467561126
Name:PAUL A. GRIFFIN, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:PAUL A. GRIFFIN, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:WEST HILLS MEDICAL GROUP, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-935-5555
Mailing Address - Street 1:1165 PHELPS AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210-9663
Mailing Address - Country:US
Mailing Address - Phone:559-935-5555
Mailing Address - Fax:559-935-2827
Practice Address - Street 1:1165 PHELPS AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9663
Practice Address - Country:US
Practice Address - Phone:559-935-5555
Practice Address - Fax:559-935-2827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51583207Q00000X
CAA56516207R00000X
CAA90195207R00000X
CAA80314208000000X
CAPA12399363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ62486ZOtherBLUE SHIELD GROUP #
CAGR0082980Medicaid
CAGR0082980Medicaid