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General NPI Number Information
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NPI Number | 1013947712
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASE CONSULTANTS MED GP
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 201 S BUENA VISTA ST STE 440
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City | BURBANK
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State | CA
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Zip | 91505-4577
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Country | US
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Telephone | 818-500-0935
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Fax | 818-500-0728
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Provider Business Mailing Address
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Address Line | 4400 W RIVERSIDE DR STE 110-440
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City | BURBANK
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State | CA
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Zip | 91505-4046
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Country | US
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Telephone | 818-500-0935
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Fax | 818-500-0728
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Authorized Official
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Title or Position | MD
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Name | JOHN HARRIS
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Credential | MD
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Telephone | 818-500-0935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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