Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A99421 | CA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A99421 | CA |
NPI | 1174775670 |
---|---|
Provider Name | Dr. Brendan Howard Grubbs |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90027-6061 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2008 |
Last Update Date | 25/09/2020 |