Healthcare Provider Details

I. General information

NPI: 1053269738
Provider Name (Legal Business Name): TANZY HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 W ADAMS BLVD APT 201
LOS ANGELES CA
90016-2654
US

IV. Provider business mailing address

5300 W ADAMS BLVD APT 201
LOS ANGELES CA
90016-2654
US

V. Phone/Fax

Practice location:
  • Phone: 310-966-7279
  • Fax:
Mailing address:
  • Phone: 310-966-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: