Justin V Graham, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

A68099 Issued in CA

Practice address

1860 Pennsylvania Ave
Suite 300B
Fairfield, CA 94533-3590

Phone

(707) 646-4180

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1386751477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LARRY LN",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946112707",
            "telephone_number": "510-270-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE",
            "address_2": "SUITE 300B",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333590",
            "telephone_number": "707-646-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JUSTIN",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A68099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8304636",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fredric Gough, MD
• Heather Robyn Gough, MSW, JD
• Richard B Gould, M.D.
• Gracious Touch Home Health Care
• Alisha Graham
• Oscar Javier Grajeda, BA
• Kate Anne Grammy, PSY.D.
• Christine Grantham
• Jaelyn Graves
• Amy Christine Gray, LMFT, ATR-P

• Infectious Disease Physician in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.