Individual
HARRIS RONALD FISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
8631 W 3RD ST, SUITE 620E, LOS ANGELES, CA 90048-5901
(310) 657-0942
(310) 652-2499
Mailing address
8631 W 3RD ST, SUITE 620-E, LOS ANGELES, CA 90048-5901
(310) 657-0942
(310) 652-2499
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
G20300
CA
2084N0400X
Neurology Physician
Primary
G20300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HG20300A
—
CA
Enumeration date
07/13/2006
Last updated
08/28/2009
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