Individual
SHANE GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7171 MACAPA DR, LOS ANGELES, CA 90068-2003
(310) 905-0848
Mailing address
7171 MACAPA DR, LOS ANGELES, CA 90068-2003
(310) 905-0848
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
99999999
ZZ
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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