Gradman, Wayne Stuart
Gradman, Wayne Stuart is an sole proprietor health care provider with primary practice located at 235 S Mccarty Dr , Beverly Hills CA 90212-3701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Gradman, Wayne Stuart can be contacted via phone (424) 653-8560.Contact Information
Primary practice address
235 S Mccarty Dr
Beverly Hills CA 90212-3701
Phone: (424) 653-8560
Fax: (310) 277-5045
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | G17696 | California |
Profile Details
| NPI number | 1104934199 |
|---|---|
| LBN Legal business name | Gradman, Wayne Stuart |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Dec 22nd, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104934199 | NPPES |
| California | Other | 00G176960 | MEDI-CAL PROVIDER NUMBER |
| California | Other | WG17696D | MEDI-CAL PROVIDER NUMBER |
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