Individual
WAYNE GROVER BRISBANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 UCLA MEDICAL PLZ STE 140, LOS ANGELES, CA 90095-6410
(310) 794-7152
(310) 794-1666
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A161053
CA
208800000X
Urology Physician
ME150237
FL
208800000X
Urology Physician
ML.60370878
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110701200
—
FL
Enumeration date
03/29/2013
Last updated
02/14/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us