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DR. CHARLES E GRAHAM M.D.

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1962487728

Individual Registrant:
DR. CHARLES E GRAHAM M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
6037 LA GRANADA PMB 1223 PMB 1223 RANCHO SANTA FE, CA 92067-1223 US
Tel: 858-756-5475  Fax: 858-756-7639

Contact information for business:
6037 LA GRANADA #1223  RANCHO SANTA FE, CA 92067-1223 US
Tel: 858-756-5475  Fax: 858-756-7639

Registration Information:
NPI: 1962487728
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
CAC31279

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DEAAG4387052CA01
NATIONAL PROVIDER INDENTIFIER1962487728CA01
STATE LICENSEC31279CA01




HEALTH CARE JOBS CA - Page 1



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