Healthcare Provider Details

I. General information

NPI: 1922149137
Provider Name (Legal Business Name): JAMES HARRISON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 10/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 PARAMOUNT BLVD SUITE 116
DOWNEY CA
90240-3843
US

IV. Provider business mailing address

9901 PARAMOUNT BLVD SUITE 116
DOWNEY CA
90240-3843
US

V. Phone/Fax

Practice location:
  • Phone: 562-928-0121
  • Fax: 562-806-3021
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT11956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: