Individual
ETHAN GEOFFREY HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1119 E MONTE VISTA AVE, VACAVILLE, CA 95688-3009
(707) 469-4610
Mailing address
PO BOX 999, 13437 ANTELOPE TRAIL, OREGON HOUSE, CA 95962-0999
(530) 692-0802
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G18727
CA
Other
Enumeration date
08/30/2005
Last updated
10/07/2021
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