Healthcare Provider Details

I. General information

NPI: 1265487896
Provider Name (Legal Business Name): CHRISTOPHER J. GRABER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD MAILCODE 111-F
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

11301 WILSHIRE BLVD, 111-F VA GREATER LOS ANGELES HEALTHCARE SYSTEM
LOS ANGELES CA
90073
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3763
  • Fax: 310-268-4928
Mailing address:
  • Phone: 310-268-3763
  • Fax: 310-268-4928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA89320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: