| NPI | 1346762903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT DANIEL SHIFFLETT Provider 310-574-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA a143697) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2017-07-14 |