Dr. Wayne Stuart Gradman
Vascular Surgeon
2080 Century Park E Suite #803
Los Angeles
, California 90067-2001
Dr. Wayne Stuart Gradman
Vascular Surgeon
2080 Century Park E Suite #803
Los Angeles
, California 90067-2001
(310) 277-4869
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Wayne Stuart Gradman
- 2080 Century Park E Suite #803
- Los Angeles, CA
- Zip : 90067-2001
- Fax : (310) 277-4869
- Phone : (310) 277-4868
Second Address
- Dr. Wayne Stuart Gradman
- 2080 Century Park E Suite #803
- Los Angeles, CA
- Zip : 90067-2001
- Fax : (310) 277-4869
- Phone : (310) 277-4868
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | G17696 | CA |
National Provider Identifier
| NPI | 1104934199 |
|---|---|
| Provider Name | Dr. Wayne Stuart Gradman |
| First Address | Los Angeles, CA 90067-2001 |
| Second Address | Los Angeles, CA 90067-2001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/08/2006 |
| Last Update Date | 25/03/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G176960 | MEDI-CAL PROVIDER NUMBER (01) | CA |
| A40160 | (02) | CA |
| WG17696D | MEDICARE PERFORMING PROV (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.