Organization
GRAIDUKEL MED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDUAMA KELLY-DOKUBO M.D. (PRESIDENT)
(626) 296-0792
Entity
Organization
Contact information
Practice address
2750 E WASHINGTON BLVD, SUITE #370, PASADENA, CA 91107-1448
(626) 296-0792
Mailing address
PO BOX 50082, PASADENA, CA 91115-0082
(626) 296-0792
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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