Jack W Griffith III, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

20A9405 Issued in CA

Practice address

8273 White Oak Ave
Rancho Cucamonga, CA 91730-7671

Phone

(909) 948-8888

Fax

(909) 948-8839

NPI assigned

Jun 29, 2006

Last updated

Jul 6, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauren Nicole-Kubeck Rodgers, PA-C

  • Physician Assistant
  • Rancho Cucamonga, CA
  • NPI 1538562103
  Medicare reassignment
• Angela Schartau, PA-C

  • Physician Assistant
  • Rancho Cucamonga, CA
  • NPI 1265073092
  Medicare reassignment

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jack W. Griffith, III, D.O.

  • Dermatology Physician
  • Rancho Cucamonga, CA
  • NPI 1104126457
  NPD (past) Authorized official
• Jack W. Griffith, III, D.O.

  • Dermatology Physician
  • Rancho Cucamonga, CA
  • NPI 1134425036
  NPD (past) Authorized official
• Del Amo Dermatology a Medical Corp

  • Dermatology Physician
  • Torrance, CA
  • NPI 1326342775
  NPD (past)
• Paul J. Gethner, M.D., Inc.

  • Clinical Medical Laboratory
  • Torrance, CA
  • NPI 1871824672
  NPD (past)
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1407884315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8273 WHITE OAK AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307671",
            "telephone_number": "909-948-8888",
            "fax_number": "909-948-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8273 WHITE OAK AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307671",
            "telephone_number": "909-948-8888",
            "fax_number": "909-948-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "JACK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "20A9405",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "20A9405",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A9405",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A9405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX94050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucy Grey, NP
• Lori Nicole Greydanus
• Alex Grice
• Laci Griffin
• Sundae Griffin
• Mercedes Grigolla
• Zachary Jaden Grimes
• Grove Internal Medicine Inc.
• Growing Professional Clinical Counselor Inc
• Danelle Guadamuz

• Dermatology Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.