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General NPI Number Information
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NPI Number | 1598143901
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Entity Type | Organization
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Legal Business Name | RODERICK O HARRIS MD INC
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 7081 N MARKS AVE # 104-331
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City | FRESNO
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State | CA
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Zip | 93711-0232
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Country | US
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Telephone | 559-495-3120
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Fax |
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Provider Business Mailing Address
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Address Line | 7081 N MARKS AVE # 104-331
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City | FRESNO
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State | CA
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Zip | 93711-0232
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Country | US
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Telephone | 559-495-3120
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Fax |
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | MISS NANCY BOLANOS
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Credential | CMC
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Telephone | 559-495-3120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G36995
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License Number State | CA
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