Individual
DR. ASIF R. HARSOLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18111 BROOKHURST ST, STE 0300, FOUNTAIN VALLEY, CA 92708-6728
(714) 962-7100
Mailing address
2650 ELM AVE, STE 201, LONG BEACH, CA 90806-1651
(562) 492-6695
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
35670
AZ
2085R0001X
Radiation Oncology Physician
Primary
A99453
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0927400
BCBS AZ PROVIDER #
AZ
01
—
125097
CARE 1ST HLTH. PLAN #
AZ
05
—
125097
—
AZ
01
—
7368874
AETNA PROVIDER #
AZ
01
—
7905964
CIGNA PROVIDER #
AZ
01
—
A99453
STATE LICENSE
CA
01
—
CR688X
PTAN
CA
Enumeration date
07/25/2006
Last updated
10/03/2012
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