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General NPI Number Information
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NPI Number | 1851512677
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Entity Type | Organization
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Legal Business Name | STEPHEN P. GRAHAM, M.D., INC.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1760 TERMINO AVE. SUITE G-21
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City | LONG BEACH
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State | CA
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Zip | 90804
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Country | US
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Telephone | 562-597-9002
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Fax | 562-597-9003
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Provider Business Mailing Address
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Address Line | PO BOX 1326
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City | BREA
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State | CA
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Zip | 92822
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Country | US
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Telephone | 562-597-9002
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Fax | 562-597-9003
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. STEPHEN PATRICK GRAHAM
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Credential | M.D.
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Telephone | 562-597-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G43382
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License Number State | CA
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