Individual
GRANT DANIEL SHIFFLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13160 MINDANAO WAY, SUITE 300, MARINA DEL REY, CA 90292-6358
(310) 574-0400
Mailing address
13160 MINDANAO WAY, SUITE 300, MARINA DEL REY, CA 90292-6358
(310) 574-0400
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
036138615
IL
207XS0117X
Orthopaedic Surgery of the Spine Physician
271020
NY
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A143697
CA
Other
Enumeration date
03/26/2010
Last updated
11/10/2016
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