Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A137455 | CA |
N | 207Q00000X | Family Doctor | 266603-1 | NY |
NPI | 1013150630 |
---|---|
Provider Name | Chris Harper |
First Address | Pomona, CA 91767-5900 |
Second Address | Pomona, CA 91768-1808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2009 |
Last Update Date | 13/09/2018 |