Individual
JUSTIN V GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1860 PENNSYLVANIA AVE, SUITE 300B, FAIRFIELD, CA 94533-3590
(707) 646-4180
Mailing address
75 LARRY LN, OAKLAND, CA 94611-2707
(510) 270-5141
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A68099
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8304636
—
CA
Enumeration date
08/24/2006
Last updated
07/11/2011
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