Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A90250 | CA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | A90250 | CA |
NPI | 1801815428 |
---|---|
Provider Name | Thomas Gregory Harris |
First Address | Pasadena, CA 91109-0730 |
Second Address | Pasadena, CA 91105-3229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 09/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BD761Z | MEDICARE PIN (01) | CA |
I32192 | (02) | CA |
P00432226 | RAIL ROAD MEDICARE (01) | CA |