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General NPI Number Information
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NPI Number | 1215556667
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Entity Type | Individual
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Provider Name | GRAHAM JAMES ELLIS DO
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Gender | Male
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 300 HILLMONT AVE
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City | VENTURA
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State | CA
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Zip | 93003-1651
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Country | US
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Telephone | 310-924-1413
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Fax |
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Provider Business Mailing Address
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Address Line | 330 E ROOSEVELT ST APT 4091
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City | PHOENIX
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State | AZ
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Zip | 85004-4312
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Country | US
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Telephone | 310-924-1413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20A24149
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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