Individual
JOEL DAVID GRODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15910 VENTURA BLVD, SUITE 1502, ENCINO, CA 91436-2802
(818) 728-9877
Mailing address
15910 VENTURA BLVD, SUITE 1502, ENCINO, CA 91436-2802
(818) 728-9877
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G65019
CA
208VP0000X
Pain Medicine Physician
G65019
CA
208VP0014X
Interventional Pain Medicine Physician
G65019
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G650190
BLUE SHIELD
CA
05
—
00G650190
—
CA
Enumeration date
05/26/2006
Last updated
03/25/2014
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