Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | G76244 | CA |
NPI | 1265424865 |
---|---|
Provider Name | Joy L Graf |
First Address | Sacramento, CA 95865-5228 |
Second Address | Sacramento, CA 95819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 12/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G76244 | (05) | CA |
I09268 | (02) |