Provider Demographics
NPI:1124004213
Name:GRAHAM, KAREN THERESE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:THERESE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2222 EAST ST
Mailing Address - Street 2:STE 365
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2056
Mailing Address - Country:US
Mailing Address - Phone:925-687-8280
Mailing Address - Fax:925-687-9744
Practice Address - Street 1:2222 EAST ST
Practice Address - Street 2:STE 365
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2056
Practice Address - Country:US
Practice Address - Phone:925-687-8280
Practice Address - Fax:925-687-9744
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA53220207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G44421Medicare UPIN
CA00A532201AMedicare ID - Type Unspecified