Healthcare Provider Details

I. General information

NPI: 1184763435
Provider Name (Legal Business Name): DANNY LEVI HARRISON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8555 FLORENCE AVE
DOWNEY CA
90240-4014
US

IV. Provider business mailing address

4250 GLENCOE AVE UNIT 1404
MARINA DEL REY CA
90292-5685
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-9351
  • Fax: 562-869-2724
Mailing address:
  • Phone: 310-989-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberA73863
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: