DR. ELLSWORTH RAYMOND GRANT (NPI# 1043233760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043233760 |
| Entity Type | Individual |
| Full Name | DR. ELLSWORTH RAYMOND GRANT |
| Credential | M.D |
| Practice Address |
1245 Wilshire Blvd Suite 801 Los Angeles CA 90017-4810 |
| Practice Telephone | 2134813948 |
| Practice Fax Number | 2134811697 |
| Mailing Telephone | 2134813948 |
| Mailing Fax Number | 2134811697 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-03-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
G73084 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G730841 | 05 | |
| CA | DEA NO. HOPE ST. | BG9701601 | 01 |
| CA | TAX ID NO. | 954893061 | 01 |
| CA | 00G730842 | 05 | |
| CA | DEA NO. WILSHIRE | BG3056012 | 01 |
| Street Address |
1245 WILSHIRE BLVD SUITE 801 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90017-4810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902805914 | Thomas Henry Kanegae | Internal Medicine | 1245 Wilshire Blvd, Ste 804, Los Angeles, CA 90017-4810 | 2005-07-20 |
| 1548736903 | Jocelyn Choy | Physician Assistant | 1245 Wilshire Blvd, Los Angeles, CA 90017-4810 | 2018-10-23 |
| 1619419819 | Mandy Littlefield | Nurse Practitioner | 1245 Wilshire Blvd, Los Angeles, CA 90017-4810 | 2016-11-06 |
| 1710431853 | Judy Justus | Physician Assistant | 1245 Wilshire Blvd, #707, Los Angeles, CA 90017-4810 | 2016-08-05 |
| 1295196756 | Suyoun Lee | Nurse Practitioner | 1245 Wilshire Blvd, Suite 703, Los Angeles, CA 90017-4810 | 2016-03-11 |
| 1588024723 | Yahan Chung | Registered Nurse | 1245 Wilshire Blvd, Suite 703, Los Angeles, CA 90017-4810 | 2016-03-01 |
| 1770964454 | Billings Orthopedics Inc | Orthopaedic Surgery | 1245 Wilshire Blvd, Suite 611, Los Angeles, CA 90017-4810 | 2015-06-17 |
| 1730570243 | Carmina-lou Paez | Nurse Practitioner | 1245 Wilshire Blvd, Suite 703, Los Angeles, CA 90017-4810 | 2015-02-05 |
| 1639569270 | Los Angeles Cardiology Associates | Nurse Practitioner | 1245 Wilshire Blvd, Suite 703, Los Angeles, CA 90017-4810 | 2015-02-04 |
| 1316357007 | Olivia A Wu | Nurse Practitioner | 1245 Wilshire Blvd, Los Angeles, CA 90017-4810 | 2014-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833617 | Guadalupe Vallejo | Licensed Vocational Nurse | 515 Columbia Avenue, #200, 515 Columbia Avenue, Los Angeles, CA 90017 | 2020-08-25 |
| 1376181768 | Nirlok Corporation | Optometrist | 750 West 7th Street, Los Angeles, CA 90017 | 2019-12-16 |
| 1689228223 | Marycarmen Beltran | Student in an Organized Health Care Education/Training Program | 333 S. Beaudry Ave., Los Angeles, CA 90017 | 2019-08-01 |
| 1639661465 | Robin B Horowitz | Counselor | 333 South Beaudry Avenue, Los Angeles, CA 90017 | 2018-06-06 |
| 1710483797 | Rose Jadidian | Pharmacist | 701 S. Flower, Ste. 3150, Los Angeles, CA 90017 | 2018-03-30 |
| 1417469875 | Marykarla Gallegos | Case Manager/Care Coordinator | 1125 W. 6th St., Suite 103, Los Angeles, CA 90017 | 2017-10-25 |
| 1134646516 | Maria Salas | Rehabilitation Practitioner | 333 S Beaudry Ave., Los Angeles, CA 90017 | 2017-08-25 |
| 1932638202 | Butterfli Technologies Inc | Transportation Broker | 865 S Figueroa St Ste 2750, Los Angeles, CA 90017 | 2017-06-08 |
| 1316493125 | Phamily Love Foundation | Community/Behavioral Health | 626 Wilshire Blvd ., Suite 910, Los Angeles, CA 90017 | 2016-08-31 |
| 1215392188 | Jessica R. Garcia-hillard | Specialist/Technologist | 1111 W. 6th St., Suite 111, Los Angeles, CA 90017 | 2015-12-21 |
| Find all providers in zip 90017 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999140 | Kamalesh K Sankhala Md Inc | Internal Medicine | 127 S San Vicente Blvd Fl 7, Los Angeles, CA 90048-3311 | 2020-07-21 |
| 1861917593 | Namphuong Tran | Internal Medicine | 10990 Wilshire Blvd Ste 300, Los Angeles, CA 90024-3937 | 2017-08-03 |
| 1922534866 | Vincent Louie Ramos Mendiola | Internal Medicine | 1441 Eastlake Avenue, Ntt 3470, Los Angeles, CA 90033 | 2017-05-11 |
| 1295153740 | Anthony Charles Bejjani | Internal Medicine | 200 Medical Plaza Suite 120, Los Angeles, CA 90095-2673 | 2014-04-02 |
| 1366737231 | Caspian Oliai | Internal Medicine | 100 Ucla Medical Plaza Suite 550, Los Angeles, CA 90095-8358 | 2011-06-18 |
| 1184920944 | Rodolfo Gutierrez | Internal Medicine | 11800 Wilshire Blvd Ste 300, Los Angeles, CA 90025-6602 | 2011-01-26 |
| 1942526934 | Joomee Shim | Internal Medicine | 1441 Eastlake Ave # Nor3440, Los Angeles, CA 90089-5018 | 2010-04-15 |
| 1669604849 | George Yaghmour | Internal Medicine | 1441 E Lake Ave, Division of Hematology and Bmt, Los Angeles, CA 90089-0112 | 2009-08-20 |
| 1902934607 | Herbert I. Rappaport, M.d., A Professional Corporation | Internal Medicine | 158 N Anita Ave, Los Angeles, CA 90049-2720 | 2007-03-02 |
| 1417083791 | James L Meltzer | Internal Medicine | 5525 West Flauson Ave Kindred Hospital, Los Angeles, CA 90056-1047 | 2007-02-23 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90017 |
Please comment or provide details below to improve the information on DR. ELLSWORTH RAYMOND GRANT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.