Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G064281 | CA |
NPI | 1114118023 |
---|---|
Provider Name | Dr. Leita J Harris |
First Address | Corona, CA 92881-3109 |
Second Address | Corona, CA 92881-3109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 23/04/2018 |