Individual
DAVID MARDELL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
NAVAL MEDICAL CTR 34800 BOB WILSON DRIVE, SAN DIEGO, CA 92134-5000
(619) 524-6912
Mailing address
NAVAL MEDICAL CTR 34800 BOB WILSON DRIVE, SAN DIEGO, CA 92134-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31163
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VAD0000
—
OK
Enumeration date
08/01/2013
Last updated
03/12/2021
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