Healthcare Provider Details

I. General information

NPI: 1861602765
Provider Name (Legal Business Name): ROBERT A. GRAHAM MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 E BULLARD AVE STE 101
FRESNO CA
93710-5474
US

IV. Provider business mailing address

728 E BULLARD AVE STE 101
FRESNO CA
93710-5474
US

V. Phone/Fax

Practice location:
  • Phone: 559-432-3040
  • Fax: 559-432-3040
Mailing address:
  • Phone: 559-432-3040
  • Fax: 559-432-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROMINA R. ROMERO
Title or Position: BUSINESS MANAGER
Credential:
Phone: 559-916-2440