Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | A44445 | CA |
NPI | 1215017223 |
---|---|
Provider Name | Bilal Harake |
First Address | San Clemente, CA 92674-1359 |
Second Address | Santa Barbara, CA 93105-4324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A444451 | (05) | CA |