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Organization
EUGENE HARRIS MD A PROFESSIONAL CORP
Active
Organization
EUGENE HARRIS MD A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRNA CHARLIN (ADMINISTRATOR)
(310) 423-9825
Entity
Organization
Contact information
Practice address
444 SO SAN VINCENTE BLVD, SUITE 603, LOS ANGELES, CA 90048-4165
(310) 423-9889
(310) 423-9891
Mailing address
444 SO SAN VINCENTE BLVD, SUITE 603, LOS ANGELES, CA 90048-4165
(310) 423-9889
(310) 423-9891
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G4367
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004123611
AETNA
CA
01
—
000G43670
BS
CA
05
—
000G43670
—
CA
01
—
P2260601
OXFORD
CA
Enumeration date
12/15/2006
Last updated
11/07/2007
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