Individual
DR. HARRY R LIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
119 S LOCUST ST, STE 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
01/25/2007
Last updated
05/04/2009
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