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Individual

MR. TRACY L. HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3914 MURPHY CANYON RD, SUITE# A226, SAN DIEGO, CA 92123-4491
(858) 751-0315
Mailing address
3914 MURPHY CANYON RD, SUITE# A226, SAN DIEGO, CA 92123-4491
(858) 751-0315

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
550000104
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
550000104
DBA - AVALON HOSPICE & PALLIATIVE CARE
CA
05
HPC01791F
CA
Enumeration date
08/31/2012
Last updated
09/10/2012
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