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Individual

THOMAS M GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-3000
(559) 353-7195
Mailing address
1903 E FIR AVE, SUITE 101, FRESNO, CA 93720-3862
(559) 441-1777
(559) 441-0726

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA14840
CA
363AS0400X
Surgical Physician Assistant
Primary
PA14840
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0PA148400
CA
Enumeration date
11/11/2006
Last updated
02/28/2022
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