Individual
MRS. JACQUELYN EILA GRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1441 EASTLAKE AVE # 3440, LOS ANGELES, CA 90089-0112
(323) 865-3900
(323) 865-0061
Mailing address
1441 EASTLAKE AVE # 3440, LOS ANGELES, CA 90089-0112
(323) 865-3900
(323) 865-0061
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
246177
CA
Other
Enumeration date
04/11/2007
Last updated
03/17/2009
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