Individual
EDWIN BORCELIS GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1845 N FAIR OAKS AVE, PASADENA, CA 91103-1620
(626) 744-6005
Mailing address
6267 W OLYMPIC BLVD, LOS ANGELES, CA 90048-5409
(626) 744-6107
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
371266
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
371266
LICENSE NUMBER
CA
Enumeration date
05/18/2007
Last updated
07/08/2007
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