Individual
CHRISTOPHER GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1 LMU DR, ATHLETIC DEPARTMENT, LOS ANGELES, CA 90045-2650
(424) 252-9816
(424) 253-2916
Mailing address
247 MARKET ST APT C, VENICE, CA 90291-5317
(424) 252-2916
(424) 253-2916
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23979
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W15428
MEDICARE GROUP ID NUMBER
CA
Enumeration date
07/13/2005
Last updated
09/23/2015
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