Provider Demographics
NPI:1538662317
Name:IVES, GRAHAM CHESTER ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:GRAHAM
Middle Name:CHESTER ARTHUR
Last Name:IVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:453 S SPRING ST STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-2074
Mailing Address - Country:US
Mailing Address - Phone:310-299-9859
Mailing Address - Fax:
Practice Address - Street 1:201 S LASKY DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3610
Practice Address - Country:US
Practice Address - Phone:310-299-9809
Practice Address - Fax:310-853-8549
Is Sole Proprietor?:No
Enumeration Date:2018-03-17
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA165935208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery