Individual
AMY HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2390 E FLORIDA AVE STE 104, HEMET, CA 92544-4711
(951) 414-4011
Mailing address
41889 E. FLORIDA AVE., HEMET, CA 92544
(951) 652-8700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-103486
IL
207Q00000X
Family Medicine Physician
Primary
G175785
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103486
—
IL
05
—
G175785
—
CA
Enumeration date
07/10/2006
Last updated
09/09/2022
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