Provider Demographics
NPI:1992864268
Name:GRIFFES, BENJAMIN W (MA, DC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:W
Last Name:GRIFFES
Suffix:
Gender:M
Credentials:MA, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18399 VENTURA BLVD STE 241
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6405
Mailing Address - Country:US
Mailing Address - Phone:818-708-0740
Mailing Address - Fax:818-708-7902
Practice Address - Street 1:18399 VENTURA BLVD STE 241
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6405
Practice Address - Country:US
Practice Address - Phone:818-708-0740
Practice Address - Fax:818-708-7902
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor