Provider Demographics
NPI:1356464739
Name:GRAHAM KEMSLEY, M.D., INC.
Entity Type:Organization
Organization Name:GRAHAM KEMSLEY, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-450-2755
Mailing Address - Street 1:16300 SAND CANYON AVE STE 911
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3709
Mailing Address - Country:US
Mailing Address - Phone:949-450-2755
Mailing Address - Fax:
Practice Address - Street 1:16300 SAND CANYON AVE STE 911
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3709
Practice Address - Country:US
Practice Address - Phone:949-450-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA421392086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty