1902305097 NPI number — DR CAROLYN GRIFFIN - BACK TO HEALTH CHIROPRACTIC CORPORATION

Table of content: MS. ANN MARIE MALDONADO M.A. (NPI 1578750071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902305097 NPI number — DR CAROLYN GRIFFIN - BACK TO HEALTH CHIROPRACTIC CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR CAROLYN GRIFFIN - BACK TO HEALTH CHIROPRACTIC CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902305097
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27674 NEWHALL RANCH RD UNIT 65
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALENCIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91355-4020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-294-0429
Provider Business Mailing Address Fax Number:
661-294-0439

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
27674 NEWHALL RANCH RD UNIT 65
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALENCIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91355-4020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-294-0429
Provider Business Practice Location Address Fax Number:
661-294-0439
Provider Enumeration Date:
02/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
GRIFFIN
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
ALEXIS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
661-294-0429

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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