Grant, Gavin Lester

Grant, Gavin Lester is an individual health care provider with primary practice located at 1400 Bristol St N #170, Newport Beach CA 92660-2911. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Grant, Gavin Lester can be contacted via phone (949) 851-5119.

Contact Information

Primary practice address
1400 Bristol St N #170 Newport Beach CA 92660-2911
Phone: (949) 851-5119
Fax: (949) 851-6269
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X DC24812 California

Profile Details

NPI number 1568446615
LBN Legal business name Grant, Gavin Lester
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Jul 8th, 2007 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568446615 NPPES
California Other DC024812 BLUE SHIELD PROVIDER

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