Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Trevor Shaddox, MD, PHD

Individual provider Specialist · NPI 1588169312

Trevor Shaddox, MD, PHD is a Specialist in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

11740 San Vicente Blvd Ste 109-606
Los Angeles, CA 90049-6610
Phone: (949) 401-6917
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Specialist Taxonomy 174400000X · Licence A167044 (CA)

Record details

NPI number1588169312
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , PHD
Sole proprietorYes
NPI enumeratedMarch 25, 2018
Last updated in NPPESJune 27, 2023
Certification dateJune 27, 2023

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