Provider Demographics
NPI:1639446248
Name:GRIFFIN, MEGHAN ULLA (LAC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ULLA
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8278 GILMAN DR
Mailing Address - Street 2:34
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-2636
Mailing Address - Country:US
Mailing Address - Phone:858-381-2287
Mailing Address - Fax:858-581-2288
Practice Address - Street 1:4747 MISSION BLVD
Practice Address - Street 2:#7
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-2541
Practice Address - Country:US
Practice Address - Phone:858-581-2287
Practice Address - Fax:858-581-2288
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14429171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist