Provider Demographics
NPI:1659081966
Name:SOLOWAY, GRANT JOSEF (DC)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:JOSEF
Last Name:SOLOWAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 S UNION ST UNIT 4042
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-6771
Mailing Address - Country:US
Mailing Address - Phone:714-270-0639
Mailing Address - Fax:
Practice Address - Street 1:3188 AIRWAY AVE STE H
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4652
Practice Address - Country:US
Practice Address - Phone:714-432-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36462111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor