Brisbane, Wayne Grover
Brisbane, Wayne Grover is an individual health care provider with primary practice located at 200 Ucla Medical Plz Ste 140 , Los Angeles CA 90095-6410. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Brisbane, Wayne Grover can be contacted via phone (310) 794-7152.Contact Information
Primary practice address
200 Ucla Medical Plz Ste 140
Los Angeles CA 90095-6410
Phone: (310) 794-7152
Fax: (310) 794-1666
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ME150237 | Florida |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | A161053 | California |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ML.60370878 | Washington |
Profile Details
| NPI number | 1346583176 |
|---|---|
| LBN Legal business name | Brisbane, Wayne Grover |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2013 |
| Last updated | Feb 14th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346583176 | NPPES |
| Florida | MEDICAID | 110701200 |
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