Organization
HARRY R LIVELY MD INC
Active
Organization
HARRY R LIVELY MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY R LIVELY MD (OWNER/PRESIDENT)
(559) 749-0223
Entity
Organization
Contact information
Practice address
119 S LOCUST ST, SUITE B, VISALIA, CA 93291-6251
(559) 749-0223
(559) 749-0886
Mailing address
PO BOX 2709, VISALIA, CA 93279-2709
(559) 749-0223
(559) 749-0886
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G56294
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G562940
—
CA
Enumeration date
08/20/2008
Last updated
04/28/2009
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