Healthcare Provider Details

I. General information

NPI: 1023544327
Provider Name (Legal Business Name): LIAM HARRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SUTTER ST STE 100
CONCORD CA
94520-2530
US

IV. Provider business mailing address

PO BOX 31396
WALNUT CREEK CA
94598-8396
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-8585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA160812
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: