Gary C Graham, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G13700 Issued in CA

Practice address

517 W 23Rd St
Merced, CA 95340-3724

Phone

(209) 383-1111

Fax

(209) 383-0104

NPI assigned

Aug 30, 2005

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1710970264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2038",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953440038",
            "telephone_number": "209-383-1111",
            "fax_number": "209-383-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 W 23RD ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953403724",
            "telephone_number": "209-383-1111",
            "fax_number": "209-383-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "GARY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G13700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G137000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lavon Hobert Goodin, DDS
• Tara Goodwyn, LVN
• Timothy Goosby, CRNA
• Jon Pratt Gossett
• Ebony A Goytia Hermosillo
• Mark Jason Granada, AGNP
• David Granados Lua
• Gorge Carlo Vizcarra Granados
• Vanessa Katrina Granados I
• Kennisha Michelle Grant

• Ophthalmology Physician in Merced, CA
• Providers in Merced, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.