Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | A62058 | CA |
NPI | 1093816613 |
---|---|
Provider Name | Graham C Tse |
First Address | Fountain Valley, CA 92708 |
Second Address | Fountain Valley, CA 92708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 01/04/2008 |