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General NPI Number Information
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NPI Number | 1407927601
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Entity Type | Individual
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Provider Name | THOMAS M GRAHAM PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/11/2006
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 9300 VALLEY CHILDRENS PL
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City | MADERA
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State | CA
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Zip | 93636-8761
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Country | US
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Telephone | 559-353-3000
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Fax | 559-353-7195
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Provider Business Mailing Address
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Address Line | 1903 E FIR AVE SUITE 101
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City | FRESNO
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State | CA
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Zip | 93720-3862
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Country | US
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Telephone | 559-441-1777
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Fax | 559-441-0726
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA14840
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA14840
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License Number State | CA
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