Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A55672 | CA |
N | 2080P0201X | Pediatric Allergist | A55672 | CA |
NPI | 1023128592 |
---|---|
Provider Name | Dr. Jeffrey M. Harris |
First Address | San Francisco, CA 94143-0001 |
Second Address | San Francisco, CA 94143-2202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A556720 | (05) | CA |
H35172 | (02) | CA |