MEDICARE: BEN HARRIS BUSINESS FUND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1164365144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEN HARRIS BUSINESS FUND

Provider Business Mailing Address
First Line	:	2075 NAVARRO AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91103-1555
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2075 NAVARRO AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91103-1555
Country	:	US
Telephone Number	:	626-319-9324
Fax Number	:

Authorized Official
Title or Position	:	CASE MANAGER
Name	:	PHOTON A MUUR
Credential	:
Telephone Number	:	626-319-9324

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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