Organization
BRIAN H. GRAHAM MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN H GRAHAM M.D. (PRESIDENT)
(619) 665-2159
Entity
Organization
Contact information
Practice address
6455 LA JOLLA BLVD, #315, LA JOLLA, CA 92037-6627
(619) 665-2159
(858) 836-1159
Mailing address
6455 LA JOLLA BLVD, #315, LA JOLLA, CA 92037-6627
(619) 665-2159
(858) 836-1159
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E90629
—
CA
Enumeration date
05/20/2015
Last updated
05/20/2015
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