Individual
TODD S HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4501 BIRCH ST, NEWPORT BEACH, CA 92660
(949) 221-0136
(949) 387-1136
Mailing address
PO BOX 12139, NEWPORT BEACH, CA 92658-5053
(949) 221-0136
(949) 387-1136
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A105121
CA
208600000X
Surgery Physician
A105121
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171098067
—
MI
Enumeration date
05/24/2005
Last updated
06/04/2019
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