Individual
DR. JYMIE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, DDS
Contact information
Practice address
533 PARNASSUS AVE # UB-10, SAN FRANCISCO, CA 94143-2208
(415) 476-8226
Mailing address
533 PARNASSUS AVE # UB-10, SAN FRANCISCO, CA 94143-2208
(415) 476-8226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DDS105772
CA
208600000X
Surgery Physician
Primary
17930
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W202657765
AETNA
CA
Enumeration date
07/09/2019
Last updated
08/07/2025
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