Dr. Ellsworth Raymond Grant
Hematology & Oncology
1245 Wilshire Blvd Suite 801
Los Angeles
, California 90017-4810
Dr. Ellsworth Raymond Grant
Hematology & Oncology
1245 Wilshire Blvd Suite 801
Los Angeles
, California 90017-4810
(213) 481-1697
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About
Features
Specialties
- Hematology & Oncology
Languages spoken
- English
Location
First Address
- Dr. Ellsworth Raymond Grant
- 1245 Wilshire Blvd Suite 801
- Los Angeles, CA
- Zip : 90017-4810
- Fax : (213) 481-1697
- Phone : (213) 481-3948
Second Address
- Dr. Ellsworth Raymond Grant
- 1245 Wilshire Blvd Suite 801
- Los Angeles, CA
- Zip : 90017-4810
- Fax : (213) 481-1697
- Phone : (213) 481-3948
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RH0003X | Hematology & Oncology | G73084 | CA |
National Provider Identifier
| NPI | 1043233760 |
|---|---|
| Provider Name | Dr. Ellsworth Raymond Grant |
| First Address | Los Angeles, CA 90017-4810 |
| Second Address | Los Angeles, CA 90017-4810 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/07/2006 |
| Last Update Date | 16/03/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G730841 | (05) | CA |
| 00G730842 | (05) | CA |
| 954893061 | TAX ID NO. (01) | CA |
| BG3056012 | DEA NO. WILSHIRE (01) | CA |
| BG9701601 | DEA NO. HOPE ST. (01) | CA |
| F40036 | (02) | 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.