| Grant Medical Clinic | |
|
274 S Atlantic Blvd Los Angeles CA 90022-1733 | |
| (323) 267-0442 | |
| Not Available |
| Full Name | Grant Medical Clinic |
|---|---|
| Speciality | General Practice |
| Location | 274 S Atlantic Blvd, Los Angeles, California |
| Authorized Official Name and Position | Ronald A Grant (OWNER) |
| Authorized Official Contact | 3232670442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant Medical Clinic Po Box 227037 Los Angeles CA 90022-0737 Ph: (323) 267-0442 | Grant Medical Clinic 274 S Atlantic Blvd Los Angeles CA 90022-1733 Ph: (323) 267-0442 |
| NPI Number | 1306062930 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 11/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306062930 | NPI | - | NPPES |
| GR0065180 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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