Individual
DR. GRANT WILLIAM JIRKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1441 EASTLAKE AVE # NTT3440, LOS ANGELES, CA 90089-4405
(323) 865-3823
Mailing address
1441 EASTLAKE AVE # NTT3440, LOS ANGELES, CA 90089-4405
(323) 865-3823
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT220309
PA
207RH0003X
Hematology & Oncology Physician
Primary
187091
CA
Other
Enumeration date
04/09/2020
Last updated
11/20/2023
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