Organization
GRANT D. SHIFFLETT, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT DANIEL SHIFFLETT M.D. (PROVIDER)
(310) 574-0400
Entity
Organization
Contact information
Practice address
13160 MINDANAO WAY STE 300, MARINA DEL REY, CA 90292-6393
(310) 574-0400
Mailing address
13160 MINDANAO WAY STE 170, MARINA DEL REY, CA 90292-6393
(310) 881-3688
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A143697
CA
Other
Enumeration date
07/14/2017
Last updated
07/14/2017
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