Provider Demographics
NPI:1043472871
Name:DEGRAFT-JOHNSON, JOHN B (MD,)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:DEGRAFT-JOHNSON
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
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Mailing Address - Street 1:1541 FLORIDA AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4438
Mailing Address - Country:US
Mailing Address - Phone:209-575-5836
Mailing Address - Fax:209-577-1040
Practice Address - Street 1:1541 FLORIDA AVE STE 305
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4439
Practice Address - Country:US
Practice Address - Phone:209-575-5836
Practice Address - Fax:209-577-1040
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2024-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPENDING208G00000X
CAA104894208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)