Individual
MRS. DARLA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADC
Contact information
Practice address
8310 BAXTER WAY, RIVERSIDE, CA 92504-4302
(951) 689-9366
Mailing address
8310 BAXTER WAY, RIVERSIDE, CA 92504-4302
(951) 689-9366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
330015CN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33352
DRUG MEDI-CAL
CA
Enumeration date
11/24/2008
Last updated
11/24/2008
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