Individual
DR. DONALD S HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 SAN PABLO ST, 2ND FLOOR, LOS ANGELES, CA 90033-5313
(323) 442-8541
(323) 442-8755
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-8541
(323) 442-8755
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
G51370
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G513700
BLUE SHIELD
CA
05
—
00G513700
—
CA
01
—
00G513700G56
CAL-OPTIMA
CA
01
—
300031906
RAIL ROAD
CA
Enumeration date
06/27/2006
Last updated
04/23/2014
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