Individual
WAYNE WILLIAM GRODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 206-6581
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
C40899
CA
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
Primary
C40899
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
C40899
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C408990
—
CA
Enumeration date
06/24/2006
Last updated
07/06/2023
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