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General NPI Number Information
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NPI Number | 1881689404
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Entity Type | Individual
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Provider Name | PETER BRUCE HARRISON MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 1 POST ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-5203
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Country | US
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Telephone | 415-692-9155
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Fax |
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Provider Business Mailing Address
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Address Line | 31 HUMBOLDT CT
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City | PACIFICA
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State | CA
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Zip | 94044-4443
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Country | US
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Telephone | 650-355-3955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 145447
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License Number State | NY
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