DR. BRIAN W. HARRIS M.D., NPI 1285687574 — LOS ANGELES (CA)

NPI 1285687574

13+ Years Experience Individual

DR. BRIAN W. HARRIS M.D.

05/18/2006
PROVIDER ENUMERATION DATE
07.09.2007
LAST UPDATE DATE
1285687574
NPI NUMBER

About DR. BRIAN W. HARRIS

DR. BRIAN W. HARRIS is a provider established in LOS ANGELES, CA. The NPI number of DR. BRIAN W. HARRIS is 1285687574 and was assigned on 05/18/2006. The practitioners primary taxonomy code is: 207P00000X with license number: G70720 CA .

Mailing address

  • City: BURBANK
  • State: CA
  • Postal code: 915055019
  • Phone: 8185570135
  • Fax: 8185571394
  • Address: 2550 NORTH HOLLYWOOD WAY
  • Address 2: SUITE 209

Primary Practice Address

  • Region : LOS ANGELES, CA
  • NPI : 1285687574
  • Phone : 2139772423
  • Fax : 2132027028
  • Postalcode : 900172395
  • Address : 1225 WILSHIRE BOULEVARD

Additional identifiers

  • Identifier: 00G707200
  • Code / Type : 5 - MEDICAID
  • Identifier state : CA

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 050618CE98412
  • Code / Type : 1 - other
  • Identifier state : CA
  • Identifier issuer : BEAR VALLEY TRAILBLAZER

Provider taxonomy - Emergency Medicine

  • Taxonomy code: 207P00000X
  • License number: G70720
  • License state: CA

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Contacts:

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  • DR. BRIAN W. HARRIS M.D.
  • Address : 1225 WILSHIRE BOULEVARD
  • Region : LOS ANGELES, CA
  • NPI : 1285687574
  • Phone : 2139772423
  • Fax : 2132027028
  • Postalcode : 900172395

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1225 WILSHIRE BOULEVARD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLOS ANGELES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code900172395
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2139772423
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2132027028
The fax number associated with the location address of the provider being identified.
NPI1285687574
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207P00000X
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Provider Enumeration Date05/18/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.09.2007
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. BRIAN W. HARRIS
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address2550 NORTH HOLLYWOOD WAY
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 209
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameBURBANK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code915055019
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number8185570135
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number8185571394
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1207P00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Emergency Medicine
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Provider License Number 1G70720
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1CA
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 100G707200
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1CA
Other Provider Identifier State #1
Other Provider Identifier 2050618CE98412
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2CA
Other Provider Identifier State #2
Other Provider Identifier Issuer 2BEAR VALLEY TRAILBLAZER
Other Provider Identifier Issuer #2
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorX
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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