Individual
PETER HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 LITTON DR STE 100, GRASS VALLEY, CA 95945-5078
(530) 272-9780
(530) 272-0156
Mailing address
PO BOX 459001, GRASS VALLEY, CA 95945-9101
(530) 272-9780
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
A136735
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2013
Last updated
12/05/2017
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