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Dr. Ellsworth Raymond Grant, MD
Hematology & Oncology Physician in Los Angeles, California
NPI 1043233760

Ellsworth Raymond Grant is a Hematology & Oncology Physician based in Los Angeles, CA and is specialized in Hematology & Oncology. Ellsworth Raymond Grant practices in Los Angeles, CA and has the professional credentials of MD. The NPI Number for Ellsworth Raymond Grant is 1043233760 and holds a License No. G73084 (California).

The current practice location address for Ellsworth Raymond Grant is 1245 Wilshire Blvd, Los Angeles, CA and can be reached out via phone at 213-481-3948 and via fax at 213-481-1697.

Location: 1245 Wilshire Blvd, Los Angeles, CA, 90017-4810
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043233760
Provider Name
Ellsworth Raymond Grant
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1245 Wilshire Blvd, Los Angeles, CA, 90017-4810
Phone Number
213-481-3948
Fax Number
213-481-1697
Provider Enumeration Date
07/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
954893061 01 CA TAX ID NO.
00G730841 05 CA
00G730842 05 CA
institution
Provider Business Practice Location Address Details
Address
1245 Wilshire Blvd
City
Los Angeles
State
California
Zip
90017-4810
Phone Number
213-481-3948
Fax Number
213-481-1697
person
Provider Business Mailing Address Details
Address
1245 Wilshire Blvd
City
Los Angeles
State
California
Zip
90017-4810
Phone Number
213-481-3948
Fax Number
213-481-1697
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Hematology & Oncology
Taxonomy
207RH0003X
License No.
G73084 (California)
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
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