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Trevor Shaddox, MD,PHD
Student in an Organized Health Care Education/Training Program in Los Angeles, California
NPI 1588169312

Trevor Shaddox is a Student in an Organized Health Care Education/Training Program based in Los Angeles, CA. Trevor Shaddox practices in Los Angeles, CA and has the professional credentials of MD,PHD. The NPI Number for Trevor Shaddox is 1588169312 and holds a License No. A167044 (California).

The current practice location address for Trevor Shaddox is 11740 San Vicente Blvd Ste 109-606, Los Angeles, CA and can be reached out via phone at 949-401-6917.

Location: 11740 San Vicente Blvd Ste 109-606, Los Angeles, CA, 90049-6610
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588169312
Provider Name
Trevor Shaddox
Credential
MD,PHD
Provider Entity Type
Individual
Gender
Male
Address
11740 San Vicente Blvd Ste 109-606, Los Angeles, CA, 90049-6610
Phone Number
949-401-6917
Fax Number
Provider Enumeration Date
03/25/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
11740 San Vicente Blvd Ste 109-606
City
Los Angeles
State
California
Zip
90049-6610
Phone Number
949-401-6917
Fax Number
person
Provider Business Mailing Address Details
Address
11740 San Vicente Blvd Ste 109-606
City
Los Angeles
State
California
Zip
90049-6610
Phone Number
949-401-6917
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
A167044 (California)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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