| Brian H. Graham Md Inc | |
|
6455 La Jolla Blvd #315 La Jolla CA 92037-6627 | |
| (619) 665-2159 | |
| (858) 836-1159 |
| Full Name | Brian H. Graham Md Inc |
|---|---|
| Speciality | General Practice |
| Location | 6455 La Jolla Blvd, La Jolla, California |
| Authorized Official Name and Position | Brian H Graham (PRESIDENT) |
| Authorized Official Contact | 6196652159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian H. Graham Md Inc 6455 La Jolla Blvd #315 La Jolla CA 92037-6627 Ph: (619) 665-2159 | Brian H. Graham Md Inc 6455 La Jolla Blvd #315 La Jolla CA 92037-6627 Ph: (619) 665-2159 |
| NPI Number | 1437538725 |
|---|---|
| Provider Enumeration Date | 05/20/2015 |
| Last Update Date | 05/20/2015 |
| Medicare PECOS PAC ID | 1658684790 |
|---|---|
| Medicare Enrollment ID | O20150720001233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437538725 | NPI | - | NPPES |
| E90629 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Brian Hilton Graham |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1376665794 PECOS PAC ID: 2567775604 Enrollment ID: I20150720001352 |
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