Ellsworth Raymond Grant M.D

NPI 1043233760 - Internal Medicine - 207RH0003X

NPI Details
NPI 1043233760
Gender Male
Enumeration Date 07/25/2006
Last Updated 03/16/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
1245 WILSHIRE BLVD
SUITE 801
LOS ANGELES CA, 90017-4810, US
Phone (213) 481-3948
Fax (213) 481-1697
Business Location
1245 WILSHIRE BLVD
SUITE 801
LOS ANGELES CA, 90017-4810, US
Phone (213) 481-3948
Fax (213) 481-1697
Toxanomy
Taxonomy Code 207RH0003X
License State California
License Number G73084
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According to our database, Dr. Ellsworth Raymond Grant M.D NPI is 1043233760, taxonomy code is 207RH0003X and license number is G73084, license state is located at California. Ellsworth Raymond Grant M.D physically located at 1245 Wilshire Blvd, Los Angeles CA, 90017-4810. NPI Number Ellsworth Raymond Grant M.D has the Individual type.

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1043233760 NPI number is provided on an as is basis without warranty of any kind. 1043233760 is maintained by the National Plan & Provider Enumeration System. The contents of Ellsworth Raymond Grant M.D are for informational purposes only.