Healthcare Provider Details

I. General information

NPI: 1184757080
Provider Name (Legal Business Name): ISIAH HARRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 11/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 PRICE AVE STE 200
REDWOOD CITY CA
94063-1433
US

IV. Provider business mailing address

1 DANIEL BURNHAM CT STE 110C
SAN FRANCISCO CA
94109-0456
US

V. Phone/Fax

Practice location:
  • Phone: 415-964-5618
  • Fax:
Mailing address:
  • Phone: 415-964-5618
  • Fax: 415-964-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number47833
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA121028
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA121028
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: