Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | G59238 | CA |
NPI | 1447372974 |
---|---|
Provider Name | Dr. Harris R Stutman |
First Address | Huntington Beach, CA 92648-4920 |
Second Address | Long Beach, CA 90806-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 08/07/2007 |