| Jeff Harris, M.d. A Medical Corporation | |
|
23805 Stuart Ranch Rd. #310 Malibu CA 90265 | |
| (714) 389-7420 | |
| (310) 456-9772 |
| Full Name | Jeff Harris, M.d. A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 23805 Stuart Ranch Rd. #310, Malibu, California |
| Authorized Official Name and Position | Susan Peters (OFFICE ADMINSITRATOR) |
| Authorized Official Contact | 3104561891 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeff Harris, M.d. A Medical Corporation 23805 Stuart Ranch Rd # 210 Malibu CA 90265-4856 Ph: (714) 389-7420 | Jeff Harris, M.d. A Medical Corporation 23805 Stuart Ranch Rd. #310 Malibu CA 90265 Ph: (714) 389-7420 |
| NPI Number | 1225556673 |
|---|---|
| Provider Enumeration Date | 09/06/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1658646575 |
|---|---|
| Medicare Enrollment ID | O20171003006058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225556673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | A24797 (California) | Secondary |
| Provider Name | Jeff Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437135340 PECOS PAC ID: 4486544780 Enrollment ID: I20040318001830 |
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