Provider Demographics
NPI:1659604908
Name:GRIFFIN, CHAD AVERY (PHARMD)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:AVERY
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W CARRILLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-6163
Mailing Address - Country:US
Mailing Address - Phone:805-965-9632
Mailing Address - Fax:
Practice Address - Street 1:222 W CARRILLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6163
Practice Address - Country:US
Practice Address - Phone:805-965-9632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33203183500000X
CA64063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist