| Doctor Name: | DR. EDWARD GARY GRANT |
| NPI Number: | 1063465235 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | G61910 |
| Business Practice Address: | 1520 San Pablo St Lower Level , Ste 1600 Los Angeles, CA - 900335310 |
| Business Phone Number: | 3234428541 |
| Business Fax Number: | 3234428755 |
| Mailing Address: | Po Box 31309, LOS ANGELES |
| State: | CA |
| Postal Code: | 900310309 |
| Phone Number: | 3234428541 |
| Fax Number: | 3234428755 |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 04/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | G61910 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |